bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunolocalization of vgr (BMP‐6, DVR‐6), a TGF‐β related cytokine, to Schwann cells of the rat peripheral nervous system: Expression patterns are not modulated by autoimmune disease
Authors: Schluesener Hermann J. , Meyermann R. , Jung S.
Published: December 2004

The transforming growth factors type β (TGF‐β) have been implicated in regulation of peripheral nervous system inflammation and regeneration. Here we demonstrate expression of a TGF‐β‐related bone morphogenetic protein, the vgr (BMP‐6, DVR‐6) in Schwann cells of the rat peripheral nervous system. The expression of vgr in the peripheral nervous system suggests that this factor and probably other TGF‐β‐related bone morphogenetic proteins might participate in Schwann cell function during aspects of peripheral nervous system physiology and pathology. However, we did not observe changes in expression patterns in response to autoimmune inflammation (experimental autoimmune neuritis) of the peripheral nervous system. © 1995 Wiley‐Liss, Inc.
Laser cytometric analysis of FIV‐induced injury in astroglia
Authors: Zenger Elisabeth , Collisson Ellen W. , Barhoumi Rola , Burghardt Robert C. , Danave Indrani R. , Tiffany‐Castiglioni Evelyn
Published: December 2004

Glia are the predominant brain cells infected by the lentiviruses human immunodeficiency virus (HIV) and feline immunodeficiency virus (FIV). The importance of astrocytes in maintenance of central nervous system homeostasis suggests that astrocytes are likely to play a strategic role in the progression of neurological disease in lentiviral‐infected patients. In consideration of this postulate, the ability of FIV to cause injury by infection of cultured feline astroglia was examined via vital fluorescence assays. Intracellular Ca2+homeostasis, plasma membrane permeability and fluidity, and cytosolic glutathione (GSH) levels were evaluated. Although basal intracellular Ca2+was not significantly different between groups, FIV‐infected astroglia displayed both a significant delay in development of peak Ca2+levels following ionophore application and a decrease in the amount of Ca2+released from intracellular stores. Plasma membrane lipid mobility was increased in FIV‐infected cells within 24 h of infection. Glutathione levels were affected in a dose dependent fashion. With a standard viral inoculum there was a decrease in GSH which became significant after 8 days postinfection. With a high inoculum dose there was rapid loss of cell viability with an increase in GSH in surviving cells. We have identified several cellular processes altered in FIV‐infected astroglia and our findings suggest that FIV‐infection of feline astroglia affects cellular membranes, both structurally and functionally. © 1995 Wiley‐Liss, Inc.
Phagocytic microglia during delayed neuronal loss in the facial nucleus of the rat: Time course of the neuronofugal migration of brain macrophages
Authors: Angelov D. N. , Gunkel A. , Stennert E. , Neiss W. F.
Published: December 2004

The injection of Fluoro‐Gold (FG) into the whisker pad of rats yields a stable fluorescent labeling of the motoneurons in the lateral facial subnucleus. Following resection of 8–10 mm of the facial nerve, the microglia phagocytose the FG‐preloaded neurons and assume the label. Employing this vital labeling of microglia in situ we studied the fate of same after completion of phagocytic activity. Starting at 56 days post resection (DPR) the FG‐labeled microglia spread out from the lateral facial subdivision and invaded the entire facial nucleus. The quantitative analysis of this redistribution of the fluorescent marker revealed a prolonged increase in the number of labeled microglia strictly proportional to the delayed loss of neurons. The differentiation between microglia and shrunken neurons was performed with the new method of immunoquenching: the staining of vibratome sections with anti‐rat neuron‐specific enolase (NSE) combined with an ABC‐HRP kit and DAB as detector totally extinguished (quenched) all fluorescence from the pre‐labeled facial motoneurons. The fluorescent microglia were additionally stained with GSA I‐B4 and OX–42, which should completely quench all fluorescence in the section. However, a few small round cells, always closely opposed to neuronal perikarya, still fluoresced. These NSE‐negative, GSA I‐B4 and OX–42 negative, but fluorescent cells may represent a new, immunologically uncharacterized microglial cell type, that participates in neuronophagia. (c) 1995 Wiley‐Liss, Inc.
Elevated intracellular levels of cAMP induce olfactory ensheathing cells to express GAL‐C and GFAP but not MBP
Authors: Doucette R. , Devon R.
Published: December 2004

The primary olfactory pathway contains non‐myelinating glial cells, called ensheathing cells, that exhibit a variety of phenotypes depending on their immediate environment. In vivo, these cells normally possess a mixture of astrocyte‐ and Schwann cell‐specific phenotypic features. When co‐cultured with dorsal root ganglion neurons, their phenotype can become more like that of a myelinating Schwann cell. The objective of this study was to determine whether ensheathing cells would express a myelinating phenotype in culture in the absence of neurons but in the presence of cAMP analogues that are known to induce the expression of myelin associated molecules in Schwann cell cultures. The ensheathing cell cultures were initiated using the nerve fiber layers of Theiler stage 23 rat olfactory bulb primordia and were fed for 1 day to 3 weeks with serum containing (1% or 10% FBS) or serum‐free media to which was added different concentrations of dBcAMP (0.1 to 1 mM) or forskolin (10 M). These cultures were double‐labelled with a rabbit polyclonal antibody to S100 in combination with mouse anti‐GAL‐C (01 and BRD1 hybridomas) or anti‐MBP monoclonal antibodies. The remaining cultures were double‐labeled with a rabbit polyclonal antibody to GFAP in combination with the BRD1 antibody. Treatment with dBcAMP or forskolin failed to induce ensheathing cells to express MBP regardless of the concentration. On the other hand, the treatment induced approximately one tenth of the cells to express GAL‐C, and virtually all of the cells to express GFAP. These results indicate that although ensheathing cells can synthesize myelin associated molecules, the cAMP second messenger system appears to play a lesser role in controlling the expression of a myelinating phenotype in ensheathing cells than it does in Schwann cells. © 1995 Wiley‐Liss, Inc.
Expression of NMDA 2B receptor subunit mRNA in bergmann glia
Authors: Luque Juan M. , Richards J. Grayson
Published: December 2004

N‐methyl‐D‐aspartate (NMDA)‐activated glutamate receptor subunits are invariably expressed in neurons, although NMDA‐activated currents have been recently described in Bergmann glia. To date, the NMDA receptor subunit 2B (NMDAR2B) was thought not to be expressed in adult cerebellum. In the present study we provide evidence, from in situ hybridization histochemistry, that Bergmann glial cells in rat brain express mRNA encoding the NMDAR2B subunit, most probably co‐expressed with the ubiquitous NMDAR1 subunit, while transcripts for other NMDAR2 subunits (A,C,D) were either not resolved or detected. Our findings suggest that Bergmann glial cells contain the molecular machinary to synthesize the NMDA receptor 2B subunit. The role of physiological NMDA receptors in the interaction between Bergmann glia and Purkinje neurons is not yet known. © 1995 Wiley‐Liss, Inc.
Rapid TGFβ1 effects on actin cytoskeleton of astrocytes: Comparison with other factors and implications for cell motility
Authors: Gagelin Claire , Pierre Michel , Gavaret Jean‐Michel , Toru‐Delbauffe Danièle
Published: December 2004

We have previously shown that long‐term treatment of primary cultured astrocytes with TGFβ1 induces morphological changes accompanied by increases in actin and GFAP synthesis, and a profound rearrangement of the cytoskeleton. The present report describes the short‐term reorganization of actin filaments induced by TGFβ1 in rat cerebellum cultured astrocytes and in an astrocytic cell line. TGFβ1 caused the appearance of new actin and vinculin organizations, without protein synthesis. This cytoskeletal rearrangement was followed by altered cell‐cell interactions. All these changes induced by TGFβ1 were different and slower than those induced by serum, PDGF, and endothelin. TGFβ1 induced the appearance of lamellipodia, organelles found at the cell front of motile cells in low‐density cultures of immortalized astrocytes. These results indicate that the changes in the astrocyte cytoskeleton induced by TGFβ1 are probably associated with cell movement. The events promoted by TGFβ1 might help to clarify its action in the brain during embryogenesis and in tissue repair. Copy 1995 Wiley‐Liss, Inc.
Rat retinal müller cells express Thy‐1 following neuronal cell death
Authors: Dabin Isabelle , Barnstable Colin J.
Published: December 2004

In the normal rat retina the Thy‐1 antigen is a specific marker of ganglion cells, but degeneration of ganglion cells in vivo does not remove completely the expression of Thy‐1 in the retina. To reconcile these differences we have postulated that ganglion cell death could induce a glial response including the expression of Thy‐1 in Müller cells, the main glial cell type in the retina. Using immunocytochemistry, we have shown that pure cultures of Müller cells were strongly labelled with antibodies against Thy‐1. PCR amplification of cDNA reverse transcribed from Müller cell RNA indicated the presence of Thy‐1 transcripts. Double labelling experiments with anti‐Thyl and anti‐glutamine synthetase, a marker of Müller cells, indicated the presence of both antigens in the same cells. Although Müller cells expressed Thy‐1 mRNA and protein when cultured in the absence of neuronal cells, when co‐cultured with retinal neurons they were not labelled with antibodies against Thy‐1. Our results suggest that Thy‐1 is expressed by Müller cells following loss of retinal neurons. Thy‐1 may have an important function during glial response to neuron death in retina. © 1995 Wiley‐Liss, Inc.
Neuroactive steroids regulate astroglia morphology in hippocampal cultures from adult rats
Authors: Cerro Sonia Del , Garcia‐Estrada Joaquin , Garcia‐Segura Luis M.
Published: December 2004

Recent evidence indicates that astroglia may be involved in the synthesis of endogenous neurosteroids. The extension of glial fibrillary acidic protein (GFAP)‐immunoreactive astroglial cell processes was assessed in hippocampal slice cultures from adult gonadectomized male rats under the influence of the neurosteroids dehydroepiandrosterone, dehydroepiandrosterone sulfate, dehydroepiandrosterone estereate, pregnenolone, pregnenolone sulfate, and pregnenolone oleate. The effects of neurosteroids were compared to those induced by the gonadal steroids testosterone, 17ß‐estradiol and progesterone. Astrocytes in hippocampal slice cultures had a morphology that was indistinguishable from that observed in the hippocampus fixed in situ. Castration of adult male rats resulted in a significant decrease in the extension of GFAP‐immunoreactive processes, both in tissues fixed in situ and in slice cultures. In contrast, incubation of slice cultures from gonadectomized animals with pregnenolone, pregnenolone sulfate, 17ß‐estradiol, and testosterone enhanced the extension of GFAP‐immunoreactive processes. While other steroids tested did not affect this parameter, dehydroepiandrosterone and its sulfate and estereate derivatives induced the transformation of astroglial cells into hypertrophic and highly GFAP immunoreactive cells with the morphological characteristics of reactive astroglia. We conclude that neurosteroids regulate the morphology and/or GFAP distribution of astrocytes in hippocampal slice cultures from adult rats. © 1995 Wiley‐Liss, Inc.
The Na+‐Ca2+ exchange system in rat glial cells in culture: Activation by external monovalent cations
Authors: Holgado Andrea , Beaugé Luis
Published: December 2004

Cultured rat glial cells display a Na+‐Ca2+ exchange system located at the plasma membrane levels. This was evidenced by the Na+ (i)‐dependency of a Na+ (o)‐inhibitable influx of Ca2+, or reversal exchange mode. This antiporter has an external site where monovalent cations (K+, Li+, and Na+ were investigated) stimulate the exchange by a chemical action. The monovalent cation is not transported during the exchange cycle. The mechanism of that stimulation agrees with an increase in the apparent affinity of the carrier for Ca2+ (o) without effect on the maximal translocation rate. Two models can equally well account for the data: i) the formation of ECa(o) is essential for the binding of the monovalent cation, or ii) the activating cation can bind even when the carrier is free of Ca2+(o). The cations K+ and Li+ produced only stimulation, although that of K+ seem to require actions other than the chemical effect. The response to Na+ was biphasic; this can be fully explained considering that at low concentrations, Na+(o) binds preferentially to the activating monovalent site while at high concentrations it displaces Ca2+ from its external transporting site. Pure type I astrocytes displayed the same Na+‐Ca2+ exchange mechanism. © 1995 Wiley‐Liss, Inc.
Chondroitin sulfate proteoglycan staining in astrocyte‐schwann cell co‐cultures
Authors: Ghirnikar Roopa S. , Eng Lawrence F.
Published: December 2004

Transplantation of Schwann cells (SCs) in the central nervous system (CNS) for remyelination in pathological situations has been considered a promising approach. However, numerous studies have indicated that astrocytes have a restrictive effect on SC migration within the CNS. We have previously established an in vitro model which demonstrates the restrictive effect of astrocytes on SCs (Ghirnikar and Eng, Glia 4:367–377, 1994). Using this culture model, in the present study, we have characterized the molecular basis underlying astrocyte‐SC interaction and demonstrated chondroitin sulfate proteoglycan (CSP) staining in the co‐cultures. Following 1–2 weeks of incubation, CSP staining was specifically associated with SCs co‐cultured with astrocytes. Staining with antibodies specific for the different chondroitin sulfate isomers revealed the presence of both, chondroitin‐4‐ and 6‐sulfates in SCs. In contrast, SCs when cultured alone, or in the presence of astrocyte conditioned medium did not show CSP staining. These data suggest that CSP staining is associated with SCs following co‐culture with astrocytes and mediated by cell to cell contact. We hypothesize that the CSP, alone or in combination with other molecules expressed by astrocytes and/or SCs, may be involved in the restrictive effects of astrocytes on SCs. Identification of molecules involved in the unfavorable interaction between astrocytes and SCs will have an important bearing on efforts to remyelinate demyelinated axons by SC transplantation within the damaged CNS. © 1995 Wiley‐Liss, Inc.
Glutamine cycle enzymes in the crayfish giant nerve fiber: Implications for axon‐to‐glia signaling
Authors: McKinnon Elizabeth , Hargittai Pál T. , Grossfeld Robert M. , Lieberman Edward M.
Published: December 2004

Two of the key enzymes involved in glutamate metabolism, glutaminase and glutamine synthetase, were quantitatively localized to axons and glia of the crayfish giant nerve fiber by immunocytochemistry and electron microscopy of antibody‐linked gold microspheres. In Western blots, rabbit antisera for glutamine synthetase and glutaminase specifically recognized crayfish polypeptides corresponding approximately in size to subunits of purified mammalian brain enzymes. Glutamine synthetase immunoreactivity was found to be 11 times greater in the adaxonal glial cells than in the axon. Glutaminase immunoreactivity was found in somewhat greater concentration (2.5:1) in glia as compared to axoplasm. Glutamate immunoreactivity also was evaluated and found to be present in high concentration in both glia and axons, as might be expected for an important substrate of cellular metabolism. Using radiolabeled substrates it was demonstrated that glutamine and glutamate were interconverted by the native enzymes in the intact crayfish giant nerve fiber and that the formation of glutamine from glutamate occurred in the axoplasm‐free nerve fiber, the cellular component of which is primarily periaxonal glia.

The results of this investigation provide immunocytochemical and metabolic evidence consistent with an intercellular glutamine cycle that modulates the concentration of periaxonal glutamate and glutamine in a manner similar to that described for perisynaptic regions of the vertebrate central nervous system. These findings further corroborate previous electrophysiological evidence that glutamate serves as the axon‐to‐glial cell neurochemical signal that activates glial cell mechanisms responsible for periaxonal ion homeostasis. © 1995 Wiley‐Liss, Inc.
Alcohol abuse and dementia
Authors: King Michael B.
Published: December 2004

Elderly outpatients on the register of the Alzheimer's Disease clinic at Johns Hopkins Hospital, Baltimore, were screened for alcohol abuse, the aim being to assess the rôle of alcohol in their dementia.

Twenty one percent were found to be heavy drinkers or alcohol abusers, at some time in the past. Sixty‐four percent of these had been actively drinking at the time of onset of first symptoms of the dementia. Clinicians need to be alert to the possibility that alcohol may be an aetiological factor in their elderly patients presenting with dementia.
Ability of internists to recognize and manage depression in the elderly
Authors: Barsa John , Toner John , Gurland Barry , Lantigua Rafael
Published: December 2004

Seventy‐seven randomly selected elderly patients in a primary care internal medicine practice were assessed and rated by their internists for the presence and severity of depression. Management recommendations were recorded by internists in each case. On the same day, the patients were interviewed and scored using the SHORT‐CARE Instrument, which includes a scale of depression. A chart review a year and a half later was made to demonstrate compliance with the internists' recommendations. Results showed that internists were quite skilled at recognizing depression and responded with specific management plans, but did not follow through with their own plans for counselling of patients or referral of patients to mental health practitioners.
Dementia, depression and life satisfaction in nursing homes
Authors: Snowdon John
Published: December 2004

Of 320 elderly residents in Sydney nursing homes admitted in the previous two years, 268 (84%) were able to be tested with the Mental Status Questionnaire. 73.5% of them were found to have moderate or severe cognitive impairment. Most of the demented patients (including 57% of the severely cognitively impaired) were able to respond satisfactorily to the depression questionnaire used by Gilleard et al. (1981). Twenty‐two per cent of the 217 patients tested scored in the depressed range. It is important that staff recognize potentially treatable depressive illnesses among those aged living in institutions, even if they are also demented. This questionnaire may aid such recognition.
The effects of meclofenoxate on cognitive performance in elderly individuals with memory impairment: A placebo‐controlled study
Authors: Harris S. J. , Dowson J. H.
Published: December 2004

Twenty residents with mild to moderate memory impairment probably due to senile dementia of Alzheimer type entered a placebo‐controlled, double‐blind, crossover trial of meclofenoxate 600 mg administered twice daily for 12 weeks. Nine subjects completed the trial during which various tests of cognitive function, including a paired‐associate learning test and a word list recall test, were applied.

There was a trend towards improvement on paired‐associate learning performance suggesting a beneficial effect of meclofenoxate but none of the cognitive tests showed statistically significant improvements for meclofenoxate when compared with placebo.

The difficulties in mounting a drug trial of this nature in patients who have early dementia are discussed.
Staging of mental impairment by means of discriminant analysis
Authors: Bracco L. , Tiezzi A. , Lippi A. , Amaducci L.
Published: December 2004

By the use of discriminant analysis it was possible to obtain from a wide neuropsychological battery a few psychometric tests able to stage five levels of mental impairment in 70 healthy and demented elderly subjects, according to two canonical variables. The tests maximally discriminant among the groups were: Personal Memory items of Blessed Dementia Scale, Five Words Recall after 24 h, Paired Words Acquisition, Information/Orientation and Mental Ability items of Clifton Assessment Schedule. The accuracy of the prediction rule was evaluated on a validation set of patients. The short battery made it possible to classify correctly 90% of subjects and to follow easily the course of mental decline. The agreement between observed and predicted groups was 0.93 as calculated by the weighted kappa.

We emphasize the role of discriminant analysis in the evaluation of neuropsychological batteries for diagnostic purposes.
The influence of age on guilt expression in major depression
Authors: Small Gary W. , Komanduri Ramanujam , Gitlin Michael , Jarvik Lissy F.
Published: December 2004

To test the hypothesis, based on clinical observation, that older depressed patients express less guilt than younger ones, the authors evaluated 39 patients with major depression aged 55 years or older (mean = 67.0) and compared them to 38 depressed patients under age 55 (mean = 35.4). The results were generally in accord with the hypothesis. On observer ratings (Hamilton Depression Scale), however, it was primarily older men who expressed guilt less frequently than younger men (p = 0.01). On self‐ratings (Beck Depression Inventory), the significant differences were among women; older women employed milder expressions of guilt (p = 0.02) and fewer expressions of feelings of failure than younger women (p = 0.025). These findings suggest that age may influence the expression of guilt in patients with major depressive disorder, and that the age effect may differ in the two sexes.
The measurement of psychological problems in the elderly in general practice
Authors: Vetter Norman J. , Jones Dee A. , Victor Christina R. , Philip Alistair E.
Published: December 2004

Interviews were performed on 1288 people aged 70 and over in an urban and a rural general practice. Information was obtained on standardized measures of anxiety, depression and memory loss. The people in the urban practice had higher (i.e. suggesting abnormal) scores for both anxiety and depression. Memory scores were higher in the rural area. These differences were basically constant for age, sex and social class groups. The urban environment appears to be associated with the excess of neurosis in the elderly at home but not to the organic changes associated with memory loss. There was a close association between physical disability and high scores on the psychological indices. Special attention must be paid to the elderly with physical disabilities for coexisting psychological problems.
A review of the contribution of housing to policies for the frail elderly
Authors: Tinker Anthea
Published: December 2004

The expected growth in numbers of very elderly people, some of whom will be frail, in the United Kingdom and elsewhere may lead to a reappraisal of policies. It is argued that housing has a crucial role to play. Research evidence is presented that most elderly people wish to remain in homes of their own and ways in which this can be achieved are discussed. For those who wish, or have, to move, a number of options are outlined. These include ordinary small housing, living with a family, granny annexes, sheltered housing, extra care housing, continuing care communities and residential care. If elderly people are to live in an appropriate setting all professional groups need to cooperate.
The use of electroconvulsive therapy in old age psychiatry
Authors: Benbow Susan Mary
Published: December 2004

All patients receiving electroconvulsive therapy (ECT) under the care of the Old Age Psychiatry service at the University Hospital of South Manchester between 1976 and 1982 were studied. Data on 193 courses were collected. Eighty per cent of patients were well or considerably improved at discharge. When relapses occurred they usually responded well to antidepressant treatment and did not indicate a poor outcome in the long term. The results confirm that ECT is a safe and effective treatment for elderly patients with severe depressive illnesses, despite the fact that many of them suffer from concurrent physical problems and that some have evidence of intellectual impairment.
Preliminary experience with the SELFCARE (D): A self‐rating depression questionnaire for use in elderly, non‐institutionalized subjects
Authors: Bird Anne S. , Macdonald Alastair J. D. , Mann Anthony H. , Philpot Michael P.
Published: December 2004

A new self‐rating depression scale for use with elderly subjects in general practice—the SELFCARE (D)—was compared with independent psychiatric assessment in 75 patients attending general practitioners at two London practices. The sensitivity was 77%, specificity 98% and positive predictive value 96%; kappa was 0·77. This preliminary experience suggests that the SELFCARE (D) is an acceptable and economic tool for the study of depression in elderly patients in a primary care setting.
Reversible dementia
Authors: Byrne E. Jane
Published: December 2004

The term reversible dementia is often a misnomer for other syndromes which globally impair cognitive function such as acute and subacute confusional state and subcortical dementia. Evidence from studies on the investigation of dementia and case reports of conditions traditionally held to cause reversible dementia (normal pressure hydrocephalus, vitamin B12 deficiency, subdural haematoma) suggest that cortical dementia is not often a treatable syndrome. Acute or subacute confusional states and subcortical dementia are more typically associated with treatable or reversible causes of brain dysfunction. Diagnosis of these syndromes may identify those patients (especially those of advanced years) who should be extensively investigated.
Late paraphrenia: Neuropsychological impairment and structural brain abnormalities on computed tomography
Authors: Naguib Mohsen , Levy Raymond
Published: December 2004

Forty‐three patients with ‘late paraphrenia’ were subjected to detailed clinical and psychological assessment and computed tomography (CT). The paraphrenics had significantly larger lateral cerebral ventricles and greater cognitive deficits than a group of 40 age‐matched normal volunteers. Group comparisons within the patients, between those with particularly large ventricular brain ratio (VBR) (equal or more than two standard deviations above the control mean) and the rest of the group, showed that the extent of ventricular enlargement had no direct bearing on the clinical presentation of the paraphrenic syndrome. The results suggest that ventricular enlargement may have preceded the onset of overt symptoms by a period of years and probably served as a non‐specific risk factor for the development of the disorder. The unimodal distribution of VBR values suggests that paraphrenia, at least at a brain structural level, is a unitary condition. It also indicates the presence of subcortical pathology which might be in part responsible for the cognitive dysfunction elicited.
A memory clinic for the early diagnosis of dementia
Authors: Philpot Michael P. , Levy Raymond
Published: December 2004

The aims and experience of work in a specialist memory assessment clinic are described with reference to the first 100 patients attending the service. Fifty‐one patients were found to suffer from dementia and a further 26 from mild but significant memory disorder. The open referral system proved a relatively efficient way of identifying patients with mild or early dementia of Alzheimer type.
Mental health and contact with primary care services in old age
Authors: Morgan Kevin , Dallosso Helen , Ebrahim Shah , Arie Tom , Fentem Peter
Published: December 2004

Profiles of mental and physical health status and reports of contact with primary care and personal social services were obtained from 979 individuals aged 65 years and over randomly selected from the Nottinghamshire Family Practitioner Committee's records. On the basis of personal disturbance scores derived from the Symptoms of Anxiety and Depression scale (SAD) administered at the time of interview, respondents were classified as psychiatrically ‘normal’, ‘borderline’ or ‘ill’. Those classified as psychiatrically ‘ill’ were significantly more likely to report recent contact with both general practitioners and certain personal social services than were those classified as psychiatrically ‘normal’. Intermediate levels of contact were found among those classified as borderline (between normal and ill). The prescription and use of psychotropic drugs showed a similar mental health gradient. While SAD scores were positively and significantly related to the number of reported physical health problems, the overall correlation between mental and physical health scales was modest (rho = 0.41, p < 0.001). These results indicate that while mental health problems are clearly influential in determining family doctor consultations among the elderly, a substantial number of emotionally disturbed elderly people do not consult their general practitioners during the currency of their symptoms.
Liaison referrals to a department of psychiatry for the elderly 1984–5
Authors: Benbow Susan Mary
Published: December 2004

Patients referred for liaison consultation to a Department of Psychiatry for the Elderly were studied over 12 months. One hundred and twelve patients were referred by hospital doctors and most of these were seen on consultations within the hospital. These patients had more physical problems than those referred from the community over that period. The absence of a formal psychiatric diagnosis does not mean that psychiatric skills cannot be useful in managing a patient. Many elderly physically ill people present complex problems and the old age psychiatry service can play a valuable role in providing liaison consultations to other departments within the general hospital.
The effect of age on the plasma levels of amoxapine and its major metabolite in depressed patients
Authors: Aoba Anri , Yamaguchi Noboru , Tsuneizumi Tomohiro , Chishima Tatsuo , Tsuzura Michinori , Sakai Takashi , Negishi Kyoichiro , Tagaki Hiroyuki , Hasegawa Kazuo , Kitani Kenichi , Shibata Makiko
Published: December 2004

Twenty‐eight depressed patients receiving amoxapine with ages ranging from 21 to 68 years (male 12, female 16) were studied in order to clarify the age effect on plasma levels of amoxapine and its major active metabolite, 8‐OH amoxapine. Plasma amoxapine levels were determined by both radioreceptor assay (RRA) and gas liquid chromatography (GLC). Plasma levels of 8‐OH amoxapine were also determined by GLC.

A highly significant correlation was found for plasma levels of amoxapine determined by RRA and GLC (r = 0.88, p < 0.001). There was no significant correlation between the amoxapine daily dose (mg/kg) and its plasma levels determined either by RRA or GLC. The ratios of plasma amoxapine level by RRA and GLC to daily dose significantly increased with advancing age (p < 0.05) and a significant positive correlation was also found between the ratio of plasma level of 8–OH amoxapine to daily dose and the age of the patients (p < 0.01), suggesting that the plasma 8‐OH amoxapine levels were more strongly affected by age than the parent drug. These results indicate that the metabolism of amoxapine in the liver decreases with age as well as that of other tricyclic antidepressants reported previously. The higher correlation of 8‐OH amoxapine with patient's age may be mainly due to its renal excretion which may also decrease with age.
Plasma cholinesterase activities in dementias, depressions and schizophrenia
Authors: Chipperfield Barbara , Smith Timothy A. D. , Moyes Isabel C. A.
Published: December 2004

Plasma cholinesterase activities were measured in a group of elderly patients and controls. Total cholinesterase activity was found to be decreased to a just significant extent in those suffering from endogenous depression when compared to normal controls. There was a highly significant decrease in cholinesterase activity in the plasma of patients suffering from senile dementia of Alzheimer type (SDAT) but not in those suffering from multi‐infarct dementia, neurotic depression or chronic schizophrenia. There was a just significant correlation between total cholinesterase and acetylcholinesterase activity in the plasma of patients suffering from SDAT and the degree of dementia. There were also significant differences between patients with SDAT and MID, and patients with endogenous and reactive depression. The potential use of such tests is discussed.
Sulpiride and placebo in depressed elderly outpatients: A double‐blind study
Authors: Kivelä Sirkka‐Liisa , Lehtomäki Erkki
Published: December 2004

In a controlled double‐blind study, sulpiride 100–200 mg daily or placebo was administered over a five‐month period to 22 and 24 depressive elderly outpatients. The majority of the patinets in both groups were diagnosed as suffering from relatively mild degrees of depression, i.e. from dysthymic disorder (chronic depression) or atypical depression. According to the Hamilton Rating Scale for Depression, the average symptomatology decreased from 19.7 to 15.7 points in the sulpiride group and from 22.8 to 17.0 points in the placebo group. The scores of three patients in the sulpiride group and those of four patients in the placebo group decreased by 50% or more. The corresponding figures for a decrease of 25–49% were six and nine, respectively. The effect of sulpiride on depressive symptoms did not differ from the effect of placebo. The results showed that sulpiride in small doses had no antidepressant effects on elderly patients suffering from relatively mild degrees of depression, i.e. from dysthymic disorder (chronic depression) or atypical depression.
Relationship between DST and the serotonergic system. Results from treatments with two 5‐HT reuptake blockers in dementia disorders
Authors: Balldin Jan , Gottries C. G. , Karlson Ingvar , Lindstedt Göran , Lérngström Göran , Svennerholm Lars
Published: December 2004

Dexamethasone suppression test (DST) were performed in patients with dementia of the Alzheimer type and multiinfarct dementia. Test–retest reliability was found to be high in dementia patients if they were inpatients and environmental factors were dept stable. In this group 14% were non‐suppressors. If outpatients were investigated, admitted to hospital for only a few days, the test–retest reliability was low. In these patient groups 39–56% were non‐suppressors.

Treatment with the serotonergic (5‐HT) uptake inhibitor citalopram significantly reduced the postdexamethasone cortisol levels as well at 08.00 am as at 03.00 pm the day after intake of 1 mg dexamethasone (after 10 h and 17 h respectively). Citalopram treatment also caused significant reduction of the cerebrospinal fluid (CSF) levels of 5‐hydroxyindolacetic acid (5‐HIAA) and 3‐methoxy 4‐hydroxyphenylglycol (HMPG). A correlation was seen between the citalopram‐induced reduction of 5‐HIAA levels in CSF and the degree of dexamethasone‐induced suppression of cortisol concentrations after the treatment period. Treatment with the 5‐HT uptake inhibitor alaproclate, with a regional selectivity principally to the limbic system, had little effect on the postdexamethasone cortisol levels. The results suggest a relation between the abnormal DST in dementia and a disturbed hypothalamic 5‐HT function.
Mental disorder among nursing home patients: Preliminary findings from the national nursing home survey pretest
Authors: Burns Barbara J. , Larson David B. , Goldstrom Ingrid D. , Johnson Wayne E. , Taube Carl A. , Miller Nancy E. , Mathis Evelyn S.
Published: December 2004

Ninety‐six per cent of mentally ill elderly persons who are not in the community reside in nursing homes, yet the mental health care they receive here is minimal or unavailable. Data are presented from the 1984 pretest of the National Nursing Home Survey. Five hundred and twenty‐six patients in 112 nursing homes in four US metropolitan areas were sampled. Overall, the prevalence of mental disorder was found to be 68%; 39% of the patients had a diagnosis of organic brain syndrome (OBS) and 29% had other mental disorders (OMD). Only about one‐third (31%) of residents had no mental disorder. These three patient groups, those with OBS, those with OMD, and those with no mental disorder, were compared on demographic, clinical, and treatment characteristics. The authors conclude that the balance between the Federal and State roles in financing care for the mentally ill in nursing homes needs to result in a more equitable system of care which does not discriminate against the mentally ill. Further, the mental health service system needs to assume greater responsibility for this population. While signnificant attention is given to residents' physical needs, behavioural and emotional problems are seriously neglected.
Selective loss of serotonin recognition sites in the parietal cortex in Alzheimer's disease
Authors: Procter Andrew W. , Middlemiss Derek N. , Bowen David M.
Published: December 2004

Numbers of serotonin (5‐HT) recognition sites of total 5‐HT1, 5‐HT1A and 5‐HT2 subtypes have been measured in frontal, temporal and parietal cortex from human brain postmortem, using binding of [3H] 5‐hydroxytryptamine (5‐HT), [3H] 8‐hydroxy‐2‐(di‐n‐propylamino) tetralin and [3H] ketanserin, respectively. A comparison has been made between 11 patients with Alzheimer's disease (AD) and 20 matched controls. Significant disease‐related differences were observed only in the parietal cortex for total 5‐HT1 and 5‐HT2 recognition sites. Age‐related decrease in numbers of 5‐HT2 recognition sites was seen in the controls, whereas an age‐related increase in the numbers of the same site was seen in AD patients. These changes are discussed in relation to disease severity and cortical nerve cell loss in ageing and AD.
Koro: Its presentation in an elderly male
Authors: Hawley Richard M. , Owen John H.
Published: December 2004

Koro is an unusual phenomenon in non‐Asian peoples and the 22 cases previously reported in the psychiatric liteature are reviewed. A further example is described in a 81‐year‐old British male who maintained typical Koro symptoms for three months associated with major depression.
Neuroleptics in the treatment of dementia
Authors: Sunderland Trey , Silver Michael A.
Published: December 2004

The authors review the history of neuroleptic treatment in dementia. The initial review of 34 studies published since 1954 was limited to the 20 double‐blind and / or placebo‐controlled studies. Sixty per cent of the studies revealed generally positive clinical results in demented patients following neuroleptic treatment. Acute side‐effects were not reported to be more prevalent or severe than in other psychiatric populations and included sedation, orthostatic hypotension, extrapyramidal reactions, and various anticholinergic symptoms. Careful assessment of the cognitive effects following neuroleptics, particularly those with known anticholinergic properties, was not performed in most of these studies and should be a focus of future prospective studies in this population. Nonetheless, it does appear that neuroleptics have a role in the treatment of patients with dementia. When used at low doses for specific purposes (i.e. treatment of agitation, hyperactivity, hallucinations, or hostility), they can both safe and effective in this population.
Impact of team approach on reducing drug costs
Authors: Karki Shyam D. , Chandra Pradeep , Holden J. M. C. , Shehata Hany
Published: December 2004

After partial success of traditional methods (closed formulary, use of generic drugs, retrospective drug usage review and continuing education) to reduce drug costs, a new‐approach ‘team approach’ was tried. This involved a clinical pharmacist and psychiatrists jointly reviewing patient drug therapies in view of a previously agreed set of guidelines. These guidelines were formulated to optimize patient therapy after a thorough review of clinical pharmacology and pharmacokinetics of drugs and pathophysiology of different psychiatric disorders. Drug cost savings of 49% and 16% were achieved in two different wards. The clinical pharmacist's active involvement accounted for a difference of 33% between the two wards.
Calcium antagonists and multi‐infarct dementia: A trial involving sequential NMR and psychometric assessment
Authors: Besson J. A. O. , Palin A. N. , Ebmeier K. P. , Eagles J. M. , Smith F. W.
Published: December 2004

A double‐blind placebo‐controlled trial of the calcium antagonist Nimodipine in 10 patients with multi‐infarct dementia (MID) shows that there is no improvement when compared with 10 patients on placebo assessed by clinical ratings and sequential NMR imaging. The value of repeated NMR imaging in measuring changes in MID is described.
Referrals to a psychogeriatic consultation–liaison service
Authors: Scott Jan , Fairbairn Andrew , Woodhouse Ken
Published: December 2004

This study reviews referrals of elderly medically ill patients to a psychogeriatric team in a district general hospital. Sociodemographic variables, medical diagnosis, source and reasons for referral, and primary DSM III diagnosis were determined. The impact on referral patterns of the introduction of a pscychogeriatric liaison attachment to complement the existing consultation service was also assessed.

In three years, 217 patients were referred, the majority from the general medical specialities. The median age of the sample was 79.5 years, more than half were female and over 60% demonstrated multiple physical pathology, particularly cerebrovascular and cardiovascular disorders. The most prevalent psychiatric diagnoses were dementia, delirium and depression. The pattern of referrals changed significantly with the introduction of the consultation–liaison service. The number of referrals increased by over 100% and there was a significant increase in the recognition and referral of functional psychiatric disorders, especially depression. The role of the geriatricians and the liaison psychiatry attachment in promoting these changes and the clinical, teaching and research advantages of this type of collaboration are discussed.
Psychiatric assessment in medical long‐term care facilities: Reliability of commonly used rating scales
Authors: Foster Jeffrey R. , Sclan Steven , Welkowitz Joan , Boksay Istvan , Seeland Irene
Published: December 2004

Clinical assessment of psychopathology includes quantifying symptoms on rating scales. Caution must be used in applying standardized instruments to new populations because their reliability may alter considerably. This study assesses the interrater reliability of six well‐known rating scales when applied to patients residing in a medical long‐term care facility. The scales include measures of depression, psychosis and cognitive impairment. The specific scales used were: Hamilton Depression Scale; Brief Psychiatric Rating Scale; Mini‐Mental State Examination; Mental Status Questionnaire; Global Deterioration Scale; and Brief Cognitive Rating Scale.
Risk factors for dementia: Evidence from the liverpool study of continuing health in the community
Authors: Dewey Michael E. , Davidson Ian A. , Copeland John R. M.
Published: December 2004

One thousand and seventy residents in the community in Liverpool aged 65 and over were interviewed using the GMS–AGECAT package. Various suggested risk factors for Alzheimer's disease were examined. Our results are in line with the conclusions drawn from earlier case‐control studies: most of the factors are not associated with a change in risk. An important new result was the finding that a history of headache or dizziness led to a reduced risk of subsequent dementia. This finding is consistent with that of Heyman et al. (1984), although it was not statistically significant in their smaller study.
Changes in P‐300 latency as a result of co‐dergocrine mesylate therapy in patients with senile dementia
Authors: Breeze R. W. , Cox Sheila , Rodgers‐Cox J.
Published: December 2004

Most studies of the effects of drugs in senile dementia have used subjective rating scales to measure change in mental and cognitive function. Few have used objective measurement. The purpose of this study was to compare the latency of the P‐300 component of the event‐related auditory evoked potential before and after drug treatment. Twenty‐one patients aged 74–93 with dementia defined by a score of>10 and <25 using the Mini‐Mental Status Test of Folstein were treated with Hydergine 13.5 mg or placebo under double‐blind randomized conditions for a period of six weeks. The mean P‐300 latency in the active group showed a decrease of 60 ms whilst that of the placebo group was prolonged by 25 ms. The difference was statistically significant (p<0.5) in favour of the active drug. These data suggest that this method of assessment is sensitive to drug‐induced changes in patients with senile dementia.
The blessed dementia scale as a screening test for dementia
Authors: Erkinjuntti T. , Hokkanen L. , Sulkava R. , Palo J.
Published: December 2004

The Blessed Dementia Scale (DS) is a brief behavioural scale based on the interview of a close informant. Its validity as a screening test was evaluated in 105 demented patients and 123 community residents. The DS proved to be a sensitive and specific screening test for dementia, especially when items related to personality changes were omitted by constructing a revised DS (RDS). Both the DS and RDS correlated with the patients' neuropsychological test performance. They also differentiated patients with different degrees of dementia. In the screening of dementia the cut‐off point of 4 in the DS gave a sensitivity of 90% and a specificity of 84%. In the RDS the cut‐off point of 1.5 gave a sensitivity of 93% and a specificity of 97%. Behavioural rating scales such as the DS are valuable in the screening of dementia, especially when combined with cognitive testing. In addition they can be used in the evaluation of the degree of disability and in the planning of social support.
State of health and social situation of elderly persons living in a large city
Authors: Bergener M. , Husser J. , Kranzhoff E. U.
Published: December 2004

Data on state of health and social situation were collected from two samples of elderly people livinig in Cologne, a sample living in the community in their own homes and a sample living in institutions. There was a high prevalence of physical disorder, especially in those in residential care, and an overall prevalence of organic cerebral disorder of 5.5%. Some methodological problems of using physicians to carry out the survey rather than trained lay interviewers are presented.
Dementia, depression and subsequent institutionalization—the effect of home support
Authors: Lindsey James , Murphy Elaine
Published: December 2004

The Guy's/Age Concern Home Support Project is a prospective controlled intervention study of the effect of client‐centred home support for elderly people with dementia. Control subjects who were in institutions at six months follow‐up were significantly more depressed and physically disabled at referral than those who remained at home. Among those receiving additional home support, however, there was no difference between the depression and disability scores at referral of those who were institutionalized and those who remained at home at follow‐up. These results suggest that the high prevalence of depression and physical disability in the institutionalized elderly is due to preferential selection into institutions, and that this process is prevented by providing this form of domiciliary support.