bluuebunny/crossref_metadata_2025 huggingface dataset:
Intracellular acidification and Ca2+ transients in cultured rat cerebellar astrocytes evoked by glutamate agonists and noradrenaline
Authors: Brune Thomas , Deitmer Joachim W.
Published: December 2004

The effect of different neurotransmitters on the intracellular pH (pHi) and intracellular calcium (Ca2+i) was studied in cultured astrocytes from neonatal rat cerebellum, using the fluorescent dyes 2,7′‐bis(carboxyethyl)‐5,6‐carboxy‐fluorescein (BCECF) and Fura‐2. Application of glutamate or kainate (100 μM) in a HEPES‐buffered, CO2/HCO3−‐free saline induced a decrease in pHi and an increase in Ca2+i. Amplitude and time course of the pHi and Ca2+i transients were different. Glutamate and kainate evoked a mean acidification of 0.22 ± 0.05 (n = 29) and 0.20 ± 0.04 (n = 12) pH units, respectively. The changes in pHi and Ca2+i induced by kainate, but not by glutamate, were inhibited by 6‐cyano‐7‐dinitroquinozalin‐2,3‐dion (CNQX; 50 μM). In order to elucidate the mechanism of the agonist‐induced acidification, whether the pHi changes were secondary to the Ca2+ rises was tested. In the absence of extracellular Ca2+, the kainate‐induced Ca2+i transient was suppressed, while the intracellular acidification was only reduced by 13%. Removal of extracellular Ca2+ reduced the glutamate‐induced pHi change by 8%, while the second component of the Ca2+i transient was abolished. Application of trans‐(±)‐1‐amino‐(1S,3R)‐cyclopentadicarboxylic acid (t‐ACPD, 100 μM), a metabotropic glutamate receptor agonist, and of noradrenaline (20 μM) evoked a Ca2+i increase, but no change of pHi. D‐aspartate, which has a low affinity to glutamate receptors, but is known to be transported by the glutamate uptake system in some astrocytes, evoked an intracellular acidification, similar to that induced by glutamate, but no Ca2+i transient. The results suggest that the kainate‐induced acidification is only partly due to the concomitant Ca2+i rise, while the glutamate/aspartate‐induced acidification is mainly due to the activation of the glutamate uptake system. © 1995 Wiley‐Liss, Inc.
Olfactory bulb ensheathing glia: A unique cell type with axonal growth‐promoting properties
Authors: Ramón‐Cueto Almudena , Valverde Facundo
Published: December 2004

The olfactory bulb (OB) is a structure of the central nervous system (CNS) in which axonal growth occurs throughout the lifetime of the organism. A major difference between the OB and the remaining CNS is the presence of ensheathing glia in the first two layers of the OB. Ensheathing glia display properties that might be involved in the process of regeneration and they appear to be responsible for the permissibility of the adult OB to axonal growth. In fact, transplants of ensheathing glia can be used as promoters of axonal regeneration within the adult CNS. The axonal growth‐promoting properties of ensheathing glia make the study of this cell type interesting for understanding the mechanisms underlying axonal regeneration. Several groups have studied OB ensheathing cells extensively in an attempt to classify them within any of the known glial groups. However, this cell type does not exhibit the phenotypic features of any glial population described thus far. In this article we review the characteristics that differentiate ensheathing glia from other peripheral and central glial populations as well as the properties that involve them in axonal regeneration. The evidence suggests that ensheathing glia are unique, have their own identity, and do not belong to any previously described glial type. © 1995 Wiley‐Liss, Inc.
Inflammatory reaction in experimental autoimmune encephalomyelitis (EAE) is accompanied by a microglial expression of the βA4‐amyloid precursor protein (APP)
Authors: Banati R. B. , Gehrmann J. , Lannes‐Vieira J. , Wekerie H. , Kreutzberg G. W.
Published: December 2004

Neuropathological studies of the amyloid depositions and senile plaques in the brains of elderly patients or patients or patients diagnosed with Alzheimer's disease reveal the conspicuous presence of numerous proteins which are usually expressed during reactions of the immune system. This has led to speculations that the pathomechanism of neurodegenerative diseases might involve inflammatory processes. These considerations constitute the theoretical basis for therapeutic intervention with antiinflammatory drugs in neurodegenerative diseases.

Here, we show that the βA4‐amyloid precursor (APP) is rapidly induced in microglia in a model of experimental antoimmune encephalomyelitis (EAE). Using specific monoclonal antibodies against APP, the first glial cells newly expressing APP immunoreactivity were found at an early preclinical stage, i.e., 24 h after T‐cell transfer. At the peak of clinical disease (6 days after T‐cell transfer), numerous characteristically ramified cells were strongly positive for APP. Based on morphology and double‐labeling, most of the de novo APP‐expressing cells were identified as microglia. Additionally, APP‐immunoreactive round cells were detected in and around perivascular infiltrates. Reflecting the course of the clinical disease, the induction of APP‐immunoreactivity terminated in the postclinical stage, i.e., 14 days after T‐cell transfer.

These results support earlier work demonstration that microglia can rapidly de novo synthesise APP not in response to direct nerve injury (Banati et al: Glia 9:199, 1993a) but also in immune‐mediated disease. Apart from ist possible therapeutic relevance, such a production of APP‐reminiscent of an acute phase protein—suggests a role of APP in immune and repair mechanisms of the central nervous system. © 1995 Wiley‐Liss, Inc.
Calcium signaling in cultured rat oligodendrocytes
Authors: Takeda Margaret , Nelson Deborah J. , Soliven Betty
Published: December 2004

The syntax of neuronal‐glial or axonal‐glial interaction is frequently communicated through transient changes in internal calcium (Cai). We examined mechanisms for Cai signaling and intercellular propagation of Cai responses in cultured oligodendrocytes (OLGs) derived form adult spinal cord (SC), postnatal day 21 (P21) SC, and P21 brain. We found that (1) cultured OLGs exhibited a heterogeneous responese to norepinephrine, carbachol, ATP, histamine, and glutamate; (2) receptor‐mediated Cai increases were derived from both Ca2+ influx and intracellular Ca2+ release; (3) the percentage of responders to neuroligands varied as a function of cell origin; (4) cultured OLGs exhibited a thapsigargin‐sensitive, but not a caffeine‐sensitive, intracellular Ca2+ pool; and (5) gap junctional contacts between OLGs permitted limited intercellular propagation of mechanically stimulated Cai responses. Receptor‐mediated Cai signaling appears to occur not only in cultured OLGs but also in acutely dissociated OLGs. The heterogeneity in Cai responses as a function of cell origin may reflect the existence of OLG subsets of differences in the maturation stage of OLGs. © 1995 Wiley‐Liss, Inc.
Acute dispersion of glial cells following transplantation into the myelin‐deficient rat spinal cord
Authors: Lipsitz David , Archer David R. , Duncan Ian D.
Published: December 2004

Evaluation of glial cell migration following transplantation can be difficult as the force of the injection itself may cause the cells to become immediately dispersed. In this study we evaluated the extent of spread of cells after injection of 1 μl of a dissociated cell suspension (50,000 cells/μl) into the dorsal columns of the thoracolumbar spinal cord in the neonatal myelin‐deficient (md) rat. Spinal cords were examined at 0, 4, and 24 h after injection to determine the dispersion of cells away from the initial site of deposition. Examination of skip‐serial sections collected at 50‐μm intervals rostral and caudal to the site of transplantation showed that the injection could result in a spread of transplanted cells up to 1,600 μm. Migration should therefore be defined as the detection of cells beyond the rostral‐caudal boundaries defined by the injection deposition. Cell dispersion should be taken into account when evaluating the results of migration in previous and future experiments concerning glial cell transplantation. © 1995 Wiley‐Liss, Inc.
Dementia and depression in italian geriatric institutions
Authors: Spagnoli Alberto , Foresti Giovanni , Macdonald Alastair , Williams Paul
Published: December 2004

A random sample of 368 elderly residents in nine geriatric institutions in Milan was selected, and interviewed using the Intervista Psicogeriatrica, the modified Italian version of the OBS scale (82.1 % successfully completed) and the Depression scale (75.5 % successfully completed) of the Comprehensive Assessment and Referral Evaluation (CARE). The estimated prevalence rates of dementia and depression were 36 % and 30 % respectively, and 50 % for either or both diagnoses. Correlates of dementia were characteristics of the institutions (size, ownership, and admission criteria), age (for women), age at admission, female sex, and poor education. Correlates of depression were disability, length of stay in men (negative association), and marital status. Correlates of dementia and depression were also examined using multivariate analysis. The only significant independent effects on dementia were admission criteria of the institutions and age, while on depression were sex and marital status.
The prescription of psychotropic medication in local authority old people's homes
Authors: Mann A. H. , Graham N. , Ashby D.
Published: December 2004

22% of the elderly residents of the 12 local authority homes in one London borough were being prescribed major tranquillisers (neuroleptic) medication. Standard diagnoses of severe dementia and of depression in residents without severe dementia were associated with this prescription as was a report by the Head of Home that the resident wandent wandered and was suspicious. These findings suggested that some non ‐ demented residents who display disturbed behaviour are being prescribed this medication, as well as residents with marked dementia. As these drugs cause many unpleasant side effects, careful assessment of mental state should be carried out before they are prescribed. This survey thus highlights the need for greater input from psychiatric services into local authority homes.
Trends in self‐poisoning in the elderly 1974–1983
Authors: Lindesay James
Published: December 2004

Although the total suicide rate in England and Wales has risen between 1974 and 1983, the proportion due to self ‐ poisoning has fallen, particularly in the younger age groups. While analgesics are now the commonest means of suicidal self ‐ poisoning in both sexes and at all ages, barbiturates still account for a significant proportion of elderly suicides. Tricyclics and benzodiazepines are implicated in a relatively small proportion of suicides in old age. If removal of the means of suicide is an effective preventive strategy in the elderly, then more careful prescribing practices could lead to a lower suicide rate in this age group.
An epidemiological study of age‐related dementia in the community
Authors: Hasegawa Kazuo , Homma Akira , Imai Yukimichi
Published: December 2004

A geronto‐psychiatric epidemiological study was carried out in Kanagawa prefecture. The total sample comprised 1800 subjects randomly selected among 224 492 people aged 65 years and over. Two hundred and thirty subjects with suspected ill health, selected from the primary survey by lay raters, were individually interviewed to perform psychiatric and physical evaluations by psychiatrists and psychologists with a semi‐structured interview form. Strict criteria similar to that of DSM‐III were used to diagnose dementia. The study revealed that the prevalence of the aged with dementia in the community was 4.8%. Prevalence increased with age and showed a great predominance of vascular dementia. The prevalence of non‐vascular senile dementia in Japan is lower than that reported in studies from outside Japan. Some possible explanatory factors for this finding are discussed.
The early recognition of dementia in the elderly: A preliminary communication about a longitudinal study using the gms–agecat package (community version)
Authors: Copeland J. R. M. , McWilliam C. , Dewey M. E. , Forshaw D. , Shiwach R. , Abed R. T. , Muthu M. S. , Wood N.
Published: December 2004

A random community sample of 1070 subjects aged over 65 was interviewed by trained non‐medical interviewers using the Geriatric Mental State, community version (GMSA). A sub‐sample of 126 subjects was selected so as to contain possible early cases of dementia, pseudo‐dementia, and normal subjects; and re‐interviewed, a mean 1 year and 23 weeks later, by a group of psychiatrists in training. The computer diagnosis AGECAT, based on GMSA applied by non‐medical raters, had predicted at initial interview, nine out of twelve cases of dementia at follow‐up and five out of nine borderline cases. An Organic/Depression Index may prove useful in predicting which of those cases with early organic levels will eventually develop dementia, depression or recover.
Cognitive ability as a predictor of self‐care performance and change in the elderly
Authors: Little A. G. , Hemsley D. R. , Volans P. J.
Published: December 2004

Two measures of cognitive ability (a mental status questionnaire and a psychometric test of verbal learning and memory) were compared as predictors of three measures of self‐care (self‐report, informant ratings and performance testing). Self‐care ability of 150 elderly in residential homes was measured at baseline and after two years. Cognitive ability was significantly related to self‐care ability at baseline and 2 years and to the changes in self‐care during follow‐up. However, this relationship was moderate and complex.
The challenge of time: Clock‐drawing and cognitive function in the elderly
Authors: Shulman Kenneth I. , Shedletsky Ralph , Silver Ivan L.
Published: December 2004

This study compares the ‘clock‐drawing test’ to two standardized cognitive screens in an elderly population. A newly developed hierarchical classification of errors in clock‐drawing correlated well with the severity of scores on both cognitive and screens and also demonstrated acceptable standards for sensitivity and specificity. Clock‐drawing appears to be a practical test which can be useful for clinicians as a screen for cognitive impairment in old age and possibly as a marker of change in cognitive status.
Ward orientation training in dementia: A Single‐case study
Authors: Lam Dominic H. , Woods Robert T.
Published: December 2004

The effects of a simple training programme on the spatial disorientation of an 80‐year‐old patient suffering from dementia are reported. The patient's ability to find particular locations on the ward improved clearly in response to the training sessions. This learning was not related to learning a particular route around the ward, as may have been the case in previous reports. The success of this programme in the psychogeriatric assessment unit encouraged staff in the old people's home to which the patient was transferred to adopt similar methods.
Depression in old age: Prognosis after ECT
Authors: Godber Colin , Rosenvinge Henry , Wilkinson David , Smithies Joan
Published: December 2004

One hundred and sixty‐three patients treated with electroconvulsive therapy (ECT) in a district psychogeriatric unit during 1981 were followed up after 3 years. After the original course (mean 11·2 treatments) 51% were rated as fully recovered and 23% as much improved. Two‐thirds experienced one or more relapse within 3 years but half of these regained full remission. Of the 113 patients alive at 3 years 59% were free of depression and 29% showed mild symptoms only. Those making full initial recoveries had fared best subsequently. It is suggested that ECT has an important and generally underestimated place in the management of depression in the elderly.
Psychiatric illness in later life. A study of prevalence in a Scottish population
Authors: Bond John
Published: December 2004

This article describes a survey undertaken in 1976 of the prevalence of psychiatric illness in a total population of people aged 65 or over in the district of Clackmannan, Scotland. Using the Survey Psychiatric Assessment Schedule (Bond et al., 1980) prevalence rates of 7% for organic disorders and 22·5% for affective disorders and psychoneuroses were estimated for the total population of elderly people living at home and in institutions. This article reports logistic discriminant analyses which identify those variables which together predict the presence of psychiatric illness. Together age, functional capacity, civil status, the absence of an affective disorder or psychoneuroses and a visual impairment predict correctly whether a person has an organic disorder for 85% of the population. Together self‐perception of disabling conditions, feelings of loneliness, perceived lack of social contact, age, functional incapacity, lack of social contact, gender, visual impairment, presence of an organic disorder and hearing impairment predict correctly whether a person has an affective disorder or psychoneuroses for 81% of the population.
Comparison of minaprine and placebo in the treatment of Alzheimer's disease and multi‐infarct dementia
Authors: Passeri Mario , Cucinotta Domenico , de Mello Manuel , Bizière Kathleen
Published: December 2004

Minaprine, an aminopyridazine derivative, represents a new class of antidepressants; in addition minaprine has been shown to possess cholinomimetic properties in rodents. Thus it seemed of interest to study the efficacy and tolerance of minaprine in the treatment of depressed mood, behavioural impairment and cognitive deterioration of senile dementia. A total of 122 patients were included in this three‐month, randomized, double‐blind, placebo‐controlled, multicentric trial; 63 patients suffered from senile dementia of Alzheimer's type (SDAT) and 59 from multi‐infarct dementia (MID). In both SDAT and MID, minaprine (100 mg bid) was more effective than placebo in relieving depressed mood. In some MID patients, minaprine also improved behavioural impairment. In SDAT patients, minaprine seemed to improve some aspects of cognitive function, as judged by a limited battery of psychometric tests. Overall, minaprine appeared to be more effective in MID, although longer treatment and/or higher dosage may be necessary in SDAT. The incidence of side‐effects was low in both treatment groups.
Deliberate self‐harm in the elderly
Authors: Pierce David
Published: December 2004

This article reviews 145 patients over the age of 65 years seen at a district general hospital after deliberate self‐harm between 1973 and 1985. There was no significant change in the numbers seen per year, and they comprised 5.4% of all the hospital's self‐harm cases. The male to female ratio was 1:1·5 although the self‐harm rates for males and females over 65 in the local population were identical. Fifty‐five per cent widowed, over 90% of the patients had depressive conditions, only 3% had an established dementia, and 63% had significant physical illness. Half the patients received inpatient psychiatric treatment. Under 10% of the patients gave a history of earlier self‐harm, while both the repetition and suicide rates were very low. These findings are discussed.
Rates of depression in elderly volunteers with isolated systolic hypertension
Authors: Edlavitch Stanley , Gurland Barry J. , Golden Robert , Greenlick Merwyn , Perry H. Mitchell , Schoenberger James
Published: December 2004

In a multicentre pilot study of the treatment of 551 elderly patients with isolated systolic hypertension (SHEP), the effects on behavioural dimensions were also investigated. The presence and severity of depression, dementia and disability was measured by the SHORT‐CARE at baseline, annual follow up and, in a random half of subjects at bimonthly intervals. Remarkably low rates and levels of depression were noted in comparison with community norms; neither demographic characteristics, rates of dementia nor medication effects explained this finding. However, controlling for disability largely resolved the discrepancy in depression rates between SHEP and the community norms.
A support group for the depressed elderly
Authors: Ong Yong‐Lock , Martineau Frances , Lloyd Christa , Robbins Ian
Published: December 2004

The setting up a support group for depressed elderly patients on discharge from hospital reduced the re‐referral and readmission rate for these patients as compared with a control group not offered this therapeutic intervention. Further studies are required to substantiate this finding. However, there are many apparent clinical advantages of running such a group and this therefore should be considered as a practical form of intervention with the depressed elderly.
Serial assessment of serum calcium correlates with mental state
Authors: Byrne E. J. , Hosking D. J. , Jameson C.
Published: December 2004

Serial assessment of cognitive state using clinical and psychometric instruments correlated closely with serum calcium in an elderly woman with hyperparathyroidism. ‘Medical parathyroidectomy’ was associated with biochemical and clinical improvement but was not sustained. Following surgical removal of a parathyroid adenoma her serum calcium and her cognitive state returned to normal.
Elderly first admissions to psychiatric institutions: Findings of a nationwide Danish cohort
Authors: Kastrup Marianne
Published: December 2004

A nationwide cohort of first‐time admitted patients aged 65 years or more to Danish psychiatric institutions was followed over a 10‐year period in the Danish psychiatric register. The annual incidence rate was 3.4 males and 3.9 females per 1000. Females were more likely to get an age‐related diagnosis, had more admissions and longer stays than males.

62.6% of the males and 53.9% of the females died as patients or were discharged within one year and not readmitted. More frequently this short‐term group had a non‐psychotic disorder. 21.9% of the males and 27.2% of the females became long‐stay patients and were characterized by organic disorders. 1.9% of the males and 3.2% of the females became revolving‐door patients and were characterized by manic depressive psychoses and organic disorders. In total the annual incidence rate of ‘heavy users’ was estimated to be 0.81 males and 1.14 females per 1000.
The distribution of dementia, depression and neurosis in elderly men and women in an urban community: Assessed using the GMS–AGECAT package
Authors: Copeland J. R. M. , Gurland B. J. , Dewey M. E. , Kelleher M. J. , Smith A. M. R. , Davidson I. A.
Published: December 2004

A computerized diagnosis, AGECAT, is applied to data from random community samples of elderly people in New York and London in order to examine the distribution of mental illness between males and females. The greater proportion of dementia in females is confirmed for all AGECAT's levels of diagnostic confidence, and for depression at all levels except one. Age‐ and sex‐specific prevalence rates are quoted for each half decade between 65 and 90 years. Differences between the sexes on syndrome case and subcase levels of neurotic disorder do not reach statistical significance.
Multivariate prediction of falls in elderly inpatients
Authors: Spar James E. , la Rue Asenath , Hewes Colleen , Fairbanks Lynn
Published: December 2004

One hundred and forty falls sustained by 65 psychogeriatric inpatients of average age 77.1 were studied in an attempt to identify risk factors. Multivariate analysis revealed increased age, a diagnosis of dementia and use of tricyclic antidepressants to be positively associated with falls when comparison was made to a control group of patients treated on the same unit who did not fall. Use of high‐potency neuroleptics was negatively associated with falls in the same analysis. A second analysis failed to reveal any variables, including routine daily measurements of orthostatic change in blood pressure, to be associated with rate of falling within the group of fallers.
Validation of the hospital anxiety and depression rating scale (HADS) in an elderly psychiatric population
Authors: Kenn Chris , Wood Hazel , Kucyj Mike , Wattis John , Cunane Joe
Published: December 2004

A study was undertaken to validate the Hospital Anxiety and Depression Rating Scale in an elderly psychiatric population. The depression subscale (HAD‐D) was shown to relate well to global measures of depression and to be sensitive to changes in the severity of the depression. No conclusion could be drawn about the anxiety subscale of the HAD. The advantages of this observer‐assisted self‐rating scale in the elderly are discussed.
Do organic solvents ‘cause’ dementia?
Authors: O'Flynn R. R.
Published: December 2004

Organic solvents have a wide range of adverse effects on cerebral functioning: the acute narcotic consequences of ingestion are well recognized and have been used to produce intoxication for thousands of years. A minority of such chemicals are proven neurotoxins and are hazardous even in low concentration. Since the late 1960s concern has been expressed that working men exposed to low levels of solvents, for example painters using oil‐based products or white spirit, consistently develop varieties of psychological illness which in their severest form have been described as a ‘dementia’. An examination of the literature, however, suggests that whatever long‐term adverse effects solvents may have, they do not appear to be characteristic, in either presentation or course, of dementing illnesses.
The Alzheimer's disease assessment scale (ADAS): An instrument for early diagnosis of dementia?
Authors: Schwarb Susanne , Köberle Suse , Spiegel René
Published: December 2004

With the aim of detecting mild dementias, 94 elderly subjects who had been participating in a long‐term study since 1976 were studied by means of a new diagnostic instrument, the Alzheimer's Disease Assessment Scale (ADAS) (Rosen et al., 1984). Data available from intelligence tests performed during the course of the long‐term study were also analysed.

On the basis of an independent clinical assessment, four subjects were rated as clearly demented, seven as possibly demented, and 83 as normal. A comparison of these three groups showed that the subjects classified as demented obtained significantly poorer scores on the ADAS than did the group of normal subjects. The cognitive section of the ADAS distinguished even better between the normal and the clearly demented subjects. On the other hand, there was no indication that the ADAS was specifically sensitive to degenerative types of dementia since the subject with the highest ADAS score was suffering from vascular dementia. There were significant correlations between the score on the ADAS and the subjects' previous or current intelligence level as assessed by means of two standard intelligence tests. However, no correlation was found between any deterioration in intelligence over time (8–10 years) and the ADAS score. The three groups did not differ significantly in intelligence quotient either at the beginning of the study (1976/78) or at its end in 1986; however, there were trends in this direction.
Use of rCBF in diagnosis and follow‐up of cerebral vitamin B12 deficiency
Authors: Fäldt Roger , Dalfelt Göran , Gustafson Lars , Risberg Jarl , Thulin Anna‐Karin
Published: December 2004

Evidence for cerebral B12 deficiency was searched for in 16 patients (age range 54–94 years) with subnormal serum B12 values (<110 pmol/l) with or without anaemia using sequential regional cerebral blood flow measurement (rCBF). Three patterns of responses followed B12 substitution in 11/16 cases: marked increase of the cerebral blood flow after one week (1); complete or partial normalization of regional decreases after one week (2) or after 1–3 months (3). Mental disturbances were observed in 14/16 patients and abnormally slow EEG activity in 11/12 patients before B12 substitution. During substitution a parallel clinical improvement was observed in 5/7 cases, who could cooperate in a follow‐up study, and normalization or marked improvement of the abnormal EEG activity was observed in three cases. We propose that rCBF is a valuable tool for diagnosis and follow‐up of this deficiency state. In addition, our results indicate that prophylactic B12 substitution should be considered at serum B12 serum values above the lower normal value especially in aged patients with coexisting organic brain disease.
The relationship between mortality and mental disorder: Evidence from the Liverpool longitudinal study
Authors: Davidson Ian A. , Dewey Michael E. , Copeland J. R. M.
Published: December 2004

In 1982/83 a random community sample of 1070 people aged 65 years and over resident in Liverpool was identified. GMS data from this sample were analysed using the AGECAT computer diagnostic program and reliable and valid rates for the different mental illnesses were determined. One hundred and seventy‐nine subjects have died during the first three years of follow‐up in the longitudinal study and form the basis of the mortality data presented here. The results demonstrate a significant relationship between mortality rates and mental disorder and we discuss these findings for different diagnostic categories as well as using the ability of the AGECAT system to look at case levels.
CBM 36‐733 (2‐Methyl‐alpha‐ergokryptine) In primary degenerative dementia: Results of a european multicentre trial
Authors: Danielczyk W. , Simanyi B. , Forette F. , Orgogozo J. , Péré J. , Hugonot L. , Floris M. , Levy R. , Philpot M. , Cox J. , Hildebrand J. , Seeldrayers P.
Published: December 2004

One hundred and seventeen inpatients and outpatients with primary degenerative dementia participated in a multicentre, placebo‐controlled, parallel‐group, therapeutic study with CBM 36‐733 (2‐methyl‐alpha‐ergokryptine) lasting eight weeks. The daily dose of CBM 36‐733 was 2.0 mg, after a slow increase over 10 days. The assessment of effects relied on factors derived from the SCAG (Sandoz Clinical Assessment Geriatric) scale and the NOSIE (Nurses' Observation Scale for Inpatient Evaluation), a battery of pscyhometric tests, and overall evaluation of efficacy and tolerability (plus laboratory analyses). CBM 36‐733 was well tolerated and positive changes were seen with regard to the ‘Apathy’ factor of the SCAG scale and in psychometric tests measuring psychomotor speed, attention, and some aspects of memory. Longer‐term studies are now required to determine the clinical relevance and duration of improvements that can be achieved with CBM 36‐733 in patients suffering from primary degenerative dementia.
The clonidine test in patients with dementia disorders: Relation to clinical status and cerebrospinal fluid metabolite levels
Authors: Balldin Jan , Gottfries C. G. , Lindstedt Göran , Lérngström Göran , Svennerholm Lars
Published: December 2004

Clonidine loading tests (100μg i.v.) for growth hormone (GH) release were performed in eight patients with dementia of the Alzheimer type and four with multi‐infarct dementia. clonidine did not stimulate GH but depressed blood pressure levels. Basal GH levels correlated to clinical variables of affective symptomatology but not with monoamine levels in the cerebrospinal fluid. Treatment with a 5‐HT uptake inhibitor (citalopram) did not affect the outcome of the loading tests.
The differentiation of depression from senile dementia in the elderly
Authors: Portalska Renata Z. , Bernstein Marion
Published: December 2004

Two studies were carried out to validate the St Thomas' Questionnaire (SQSD) for use by health professionals to distinguish between cases of depression in the elderly without underlying organic involvement, and thus potentially reversible, from those of a progressive and irreversible senile dementing state. In the first study 50 patients with a diagnosis of senile dementia, 50 with functional disorders known to include an affective component and a control group of 50 coping elderly people within the district were psychologically tested. Independent assessments by a psychiatrist were also provided for the two experimental groups. After taking age and IQ differences into account using multiple regression, performance scores on the SQSD were compared between groups. Significant differences were found (p<0.01) between controls and dementing patients and between depressed patients and dementing patients, but not between depressed patients and controls. When individual subtests of the SQSD were examined, certain items were found to be of greater discriminatory value than others, and in the second study the less discriminatory items were eliminated and a shorter version of the test was administered to a further sample of 50 patients diagnosed as depressed and / or dementing. Again significant differences were found (p<0.01) between the groups, demonstrating the SQSD to be of diagnostic value in discriminating a primarily depressed state from a dementing process.
Brain changes in geriatric depression
Authors: Alexopoulos George S. , Meyers Barnett S. , Young Robert C. , Abrams Robert C. , Shamolan Charles A.
Published: December 2004

The clinical and neurobiological literature of geriatric depression which focuses on the relationship between depression and dementia is reviewed. The hypothesis that depression of late life and dementia are linked by a spectrum of underlying ageing‐associated brain changes is presented, and the implications for future research are discussed.
The role of labelling processes in the assessment of geriatric depression
Authors: Cohen Carl L. , Crosby Mabel , Zeman David
Published: December 2004

Informed by a labelling theory perspective, the authors examine the difficulties in diagnosing depression in elderly persons. Two popular diagnostic tools, the DSM‐III and depression scales, are used to illustrat the value judgements, theoretical biases, and insensitivity to geriatric norms that underlie the diagnostic decisions. The implications of these problems are discussed.
Age of onset and studies of late‐life depression
Authors: Meyers Barnett S. , Alexopoulos George
Published: December 2004

Investigations of the heterogeneity of major depression must include studies of geriatric patients. This will facilitate identification of correlates of age of onset in an age‐matched sample. The inclusion of young adult depressives could confound the affect of age and wash out a phenomenon occurring only in late life unless systematically carried out as part of the study design. Thus, a comparison of early‐onset first‐episode depressives with late‐onset first‐episode and early‐onset multiple‐episode patients who have aged provides a mathematical approach for separating the influences of multiple episodes, age at index episode and age of onset.

Studies of geriatric depressives have not demonstrated a greater role for either medical or social factors in late‐onset illness. The possibility that some cases of late‐onset depression directly result from biogenic amine depletion caused by age and that these individuals are examples of acceleration of a normal distributed rate of brain ageing remains. If this hypothesis is valid, these cases might be related to senile onset Alzheimer's disease. A longitudinal study could determine if this ‘brain failure’ hypothesis is associated with depression‐related dementia, systemic signs of accelerated ageing, a decreased interval before death, and neurotransmitter depletion at autopsy. Future investigations that carefully examine questions of age of onset, age, and clinical and biological correlates are required to address these important questions.
Elderly suicide in london: An analysis of coroners' inquests
Authors: Cattell H. R.
Published: December 2004

The article describes the social, physical and psychological features of 104 consecutive elderly suicides, using information obtained from coroners' inquests. An age and sex matched cohort of 51 accidental deaths was used as a control. The suicide cohort was significantly more depressed and in pain, had experienced more previous depressive episodes and suicide attempts, and were less confused compared to the control group. The study confirms the importance of recognized risk factors: 61% were living alone, with 9% complaining of loneliness. Only one individual, on available data, attended a day hospital or day centre. Physical illness was common, with at least 56% having ill health prior to death and 63% showing postmortem abnormalities. Twenty‐two per cent revealed abnormal cerebral pathology. Depressive illness was prominent, with 79% exhibiting depressive symptoms prior to death. Only 12 individuals were taking antidepressants and only one was on lithium. Despite contact with primary care services, only 20% had been seen by psychiatrists within three months of death. The roles of alcohol, drugs, abnormal cerebral changes and personality factors are discussed along with considerations for prevention.
Relationship between peripheral sensory disturbance and onset of symptoms in elderly paraphrenics
Authors: Soni Som D.
Published: December 2004

Four cases of paraphrenia with multiple sensory disturbances are presented in which there was a close temporal relationship between the development of a disturbance in one sensory modality and the onset of psychiatric symptoms pertaining to it. In some instances, relief of the sensory dysfunction was followed by amelioration of the corresponding psychiatric symptom. It is suggested that in the presence of the right constitutional/environmental milieu, delusions and/or hallucinations may be precipitated by the development of peripheral sensory disturbances and since the latter, not infrequently, result from a treatable disorder, paraphrenics should be investigated thoroughly before instituting neuroleptic therapy.
Prescription of psychotropic drugs in geriatric institutions
Authors: De Leo Diego , Stella Antonella G. , Spagnoli Alberto
Published: December 2004

A drug utilization study was carried out in 11 geriatric institutions for independent or dependent people in Padua. Clinical records and treatment charts of the 1533 residents were reviewed and details on sociodemographic characteristics of the population and prescription of psychotropic drugs were recorded. Mean age of the residents was 79 years and mean length of stay five years; women were 78% of residents. Psychotropic drug prescriptions were recorded in 26% of the residents; frequency of prescriptions of benzodiazepines, neuroleptics and antidepressants was respectively 21%, 8% and 4% most of the residents (74%) receiving psychotropic agents were being prescribed only one category of psychotropic drug. Duration of treatment could not be reliably assessed. Psychotropic drug use in geriatric institutions is discussed and studies from different countries are briefly reviewed. Evidence from the literature and the present study suggests that, at least in some institutions, psychotropic drug use is inappropriate.
Late paraphrenia — a follow‐up study
Authors: Hymas Nigel , Naguib Mohsen , Levy Raymond
Published: December 2004

We report a 3.7 year follow‐up study carried out on 42 patients with an original diagnosis of late paraphrenia who had had a CT scan and simple tests of cognition in addition to an assessment by means of the Geriatric Mental State Schedule. Mortality was found to be no different than in a control group. Patients showed improvement in target symptoms but exhibited a good deal of residual morbidity, particularly of motor and cognitive function. Cognitive performance, which was previously mildly impaired, showed some futher deterioration, usually falling short of clear‐cut dementia. Ventricular size on the CT scan was not a predictor of outcome. The article highlights the organic substrate of late paraphrenia but suggests that the cerebral changes are relatively subtle and slowly progressive.
The cerebral cortical appearance in late paraphrenia
Authors: Burns Alistair , Carrick Janet , Ames David , Naguib Mohsen , Levy Raymond
Published: December 2004

The cortical appearance on CT scan in patients suffering from late paraphrenia was assessed compared to that of age‐matched normal controls. There was no difference in overall cortical appearance between the two groups. However, a correlation existed between ventricular size and cortical size and between ventricular size and age in normal controls but this was not present in paraphrenia. The implications of these findings are discussed in relation to a possible structural abnormality in late paraphrenia.
Assessment of cognitive decline in dementia by informant questionnaire
Authors: Jorm Anthony F. , Scott Ruth , Jacomb Patricia A.
Published: December 2004

An informant questionnaire to measure cognitive decline in the elderly (the IQCODE) is described. The IQCODE was found to have high internal consistency reliability and to measure a general factor of cognitive decline. Scores on this questionnaire correlated highly with the Mini‐Mental State Examination and with the level of care required by the subject. Furthermore, scores were unrelated to the subject's education or occupational status.
Scatolia in elderly people with dementia
Authors: Begg A. H. , McDonald C.
Published: December 2004

Fourteen cases of scatolia (smearing of faeces) were studied and all were found to be constipated when they smeared. Relieving the constipation stopped the scatolia.
A white‐matter disease in dementia of Alzheimer's type – clinical and neuropathological correlates
Authors: Englund Elisabet , Brun Arne , Gustafson Lars
Published: December 2004

A correlative neuropathological‐clinical study was undertaken in order to analyse the possible clinical effects of the selective incomplete white‐matter infarctions (SIWI) frequently found in dementia of Alzheimer's type (DAT). The cases studied represent DAT with and without concomitant SIWI, non‐Alzheimer dementia with SIWI and cerebrovascular dementia, including multi‐infarct dementia and Binswanger's disease. The structural grey and white matter changes were examined and the clinical symptoms and signs were analysed. The occurrence of cardiovascular disease and abnormal blood pressure was studied as well. The results show that cardiovascular disease and systemic hypotension occur frequently in cases with SIWI and they are considered of pathogenetic importance for SIWI. Symptoms and signs of a non‐focal cerebrovascular/ischaemic type, mainly vertigo, fainting and a fluctuating course, are associated with SIWI. In DAT and SIWI, the clinical picture of DAT is altered accordingly, compared to DAT with normal white matter.
Double‐blind controlled withdrawal of thioridazine treatment in elderly female inpatients with senile dementia
Authors: Findlay D. J. , Sharma J. , McEwen J. , Ballinger B. R. , MaClennan W. J. , McHarg A. M.
Published: December 2004

Thirty‐six female inpatients with a clinical diagnosis of senile dementia, Alzheimer type, were entered into a doubleblind withdrawal of their established thioridazine. Over a four‐week period there were no significant differences between the two study groups in terms of cognitive function, behaviour or physical state. There was no evidence of a withdrawal phenomenon and the use of replacement medication was at a similar low level in the two groups. Although significant differences were not established in terms of side‐effect, there was a trend for greater reduction of these for the group in whom treatment was stopped. These data indicated that careful, controlled withdrawal of established thioridazine treatment is a safe procedure which may be useful in circumstances where the contribution of medication is unclear.
A systematic review of nursing home research in three psychiatric journals: 1966–1985
Authors: Larson David B. , Lyons John S. , Hohmann Ann A. , Beardsley Robert S. , Huckeba Wendy M. , Rabins Peter V. , Lebowitz Barry D.
Published: December 2004

This article presents the results of a systematic review of two decades of research on nursing home populations in three major psychiatric journals. The review indicates that very little psychiatric research has been undertaken in nursing home settings. The work that has been done is more often qualitative: case studies, program reports or reviews of the research, rather than quantitative research studies. The small amount of empirical research that has been published has suffered from sampling, design, and analytic shortcomings. Until recently, there has been little funded psychiatric research in nursing home setting, reflected in a worse than average disapproval rate for NIMH grant submissions involving nursing home populations. The implications of this review are discussed and recommendations are made for advancing this area of study among mental health professionals.
The value of CT head scan in elderly psychiatric patients
Authors: Rozenbilds Ute Y. , Gilchrist Peter N.
Published: December 2004

The authors present the results of routine CT head scans done on 80 consecutively admitted elderly psychiatric patients. Many patients had abnormal scans but in few cases were the results of major clinical importance. Patients in whom the clinical history suggests a recent change in behaviour or personality, or whose findings on physical examination have recently altered, represent a select group for whom CT scans should be considered.
Anxiety and depression scores in elderly fallers
Authors: Vetter Norman J. , Ford Diane
Published: December 2004

In the present study 674 over‐70s, living at home, were interviewed in order to ascertain their annual prevalence of falls, their general physical state, their use of medications and their degree of neuroticism, based on standard scores. Frequent falls were related to physical state and medicine usage and anxiety and depression scores. The article shows that falls per se have a relationship with the mental state of elderly people but that the major part of that relationship is mediated through other variables.
The validity of informant histories in a community study of dementia
Authors: O'Connor D. W. , Pollitt P. A. , Brook C. P. B. , Reiss B. B.
Published: December 2004

The CAMDEX is a structured interview schedule intended for use in community studies of dementia. It includes an informant interview in addition to a mental status examination and cognitive testing. In a Cambridge dementia prevalence study, the information given by informants, most of whom were relatives, was highly consistent with elderly subjects' scores on cognitive testing and with the observations made by research psychiatrists. Their reports were in serious disagreement with other parts of the asessment in only a small number of cases. Neither social class nor the relationship between informant and subject appeared to have any bearing on the consistency of informants' reports.
The reliability of the brief assessment schedule
Authors: Mann A. H. , Ames D. , Graham N. , Weyerer S. , Eichhorn S. , Platz S. , Snowdon J. , Hughes F. , Ticehurst S.
Published: December 2004

Reliability studies for the Brief Assessment Schedule between raters trained in England, West Germany and Australia have been carried out, as this instrument is now being widely used for assessing psychiatric morbidity among elderly residents in care in several countries. Interrater reliability for the dementia and depression scales for raters from the different countries working in English was high. However, the interlingual (English‐German) reliability for the dementia scale was less satisfactory.
Anxiety as an outcome symptom of depression in elderly and middle‐aged adults
Authors: Blazer Dan , Hughes Dana C. , Fowler Nancy
Published: December 2004

Early morning anxiety was reported as a symptom in 32.1% of 131 elderly and middle‐aged patients hospitalized for depression one to two years following hospitalization. Two‐thirds of those patients complaining of early morning anxiety also complained of anxiety at other times during the day. The demographic and system profile of subjects complaining of early morning anxiety did not differ on a variety of indices from subjects complaining of anxiety throughtou the day at follow‐up, except that early morning anxiety was associated with a less severe symptom profile at follow‐up. These results suggest that early morning anxiety is a less severe presentation of mixed depression/anxiety in patients who do not recover completely from an episode of major depression, regardless of age.