bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demonstration of cognitive decline in Parkinson's disease using the Cambridge Cognitive Assessment (Revised) (CAMCOG‐R)
Authors: Athey Richard J. , Walker Richard W. 
Published: September 2006

AbstractBackgroundCognitive impairment is well recognised in Parkinson's Disease (PD) but few studies have examined cognitive decline over time in such subjects. Standard clinical assessments of cognitive function, such as the MMSE, do not measure all cognitive domains and often have a ceiling effect. CAMCOG‐R provides a more comprehensive cognitive assessment allowing several different domains of cognition to be compared. It also features the ability to test ‘executive function’. CAMCOG‐R has only been reported on one previous occasion in PD subjects and this is the first study to report a follow‐up CAMCOG‐R to assess cognitive decline.MethodsIn a previously published study CAMCOG‐R was administered to a prevalent community‐based population of 94 subjects with PD with a MMSE of 25 or above. In this subsequent study 85 of the subjects (two declined and seven were deceased) underwent a follow‐up CAMCOG‐R after a mean delay of 13.1 months.ResultsThe initial, and follow‐up mean total CAMCOG‐R scores were 88.65/104 and 84.75/104 respectively, demonstrating a significant decline (p < 0.05). Significant cognitive decline (p < 0.05) was also seen across every CAMCOG‐R cognitive domain and in the executive function scores.ConclusionsA wide range of cognitive ability was again demonstrated using CAMCOG‐R in this PD population. The decline of 3.9 CAMCOG‐R points over the 13‐month period compares to other previous studies showing an annual decline of 1.6 CAMCOG points in normal elderly individuals and 12 CAMCOG points annually in those with established dementia. This study suggests that CAMCOG‐R is a useful and appropriate tool for use in follow‐up cognitive screening in PD subjects. Copyright © 2006 John Wiley & Sons, Ltd.
Relationship between periventricular and deep white matter lesions and depressive symptoms in older people. The LADIS Study
Authors: Krishnan Mani S , O'Brien John T , Firbank Michael J , Pantoni Leonardo , Carlucci Giovanna , Erkinjuntti Timo , Wallin Anders , Wahlund Lars‐Olof , Scheltens Philip , van Straaten Elisabeth C.W. , Inzitari Domenico 
Published: September 2006

AbstractBackgroundBoth types of cerebral white matter hyperintensities, periventricular (PVL) and deep white matter lesions (DWML) have been previously associated with the development of depression in older subjects. However, it remains controversial as to whether PVL, DWML, or both are most strongly associated with depression and this was the aim of the current study.MethodsIn a pan‐European multicentre study of 626 older subjects, we examined the relationship between PVL and DWML, depressive symptoms (GDS quintile), cognitive status (MMSE), hypertension and history of stroke.ResultsIn univariate analysis we found that depressive symptoms as assessed by GDS were associated with both types of white matter lesions (Spearman rho = 0.12 p = 0.002 for DWML and rho = 0.09 p = 0.01 for PVL). Using ordinal logistic regression analysis the total DWML score (p = 0.041), rather than PVL (p = 0.9) was found to predict GDS scores.ConclusionsDWML, but not PVL, were most strongly associated with depressive symptoms in this sample. As DWML (unlike PVL) are associated with vascular ischaemic damage, our findings are consistent with the ‘vascular depression’ hypothesis. Longitudinal studies are needed to clarify the time course of these relationships, in particular, whether modifying DWML alters the natural history of depression. Copyright © 2006 John Wiley & Sons, Ltd.
Preferences for routines in older people: associations with cognitive and psychological vulnerability
Authors: Bergua Valérie , Fabrigoule Colette , Barberger‐Gateau Pascale , Dartigues Jean‐François , Swendsen Joel , Bouisson Jean 
Published: September 2006

AbstractObjectivesAlthough routine activities are important to normal functioning across all phases of life, their expression in older people may be associated with cognitive and psychological vulnerability.MethodsThe relationship between these variables was explored in 235 elderly French participants from the PAQUID cohort study.ResultsCross‐sectional positive associations were found between preferences for routines, anxiety and depression levels, and cognitive complaints. General cognitive decline over a three‐year time span was also associated with a greater desire for routines at the end of this period.ConclusionsThe progressive routinization of behaviors and activities in older people is discussed as a marker of affective and cognitive vulnerability, and its understanding has potential for improving the early detection of adaptation difficulties and overall care in this population. Copyright © 2006 John Wiley & Sons, Ltd.
Dementia Care Mapping (DCM): initial validation of DCM 8 in UK field trials
Authors: Brooker Dawn J. , Surr Claire 
Published: September 2006

AbstractObjectivesThis paper describes DCM 8 and reports on the initial validation study of DCM 8.MethodsBetween 2001–2003, a series of international expert working groups were established to examine various aspects of DCM with the intention of revising and refining it. During 2004–2005 the revised tool (DCM 8) was piloted in seven service settings in the UK and validated against DCM 7th edition.ResultsAt a group score level, WIB scores and spread of Behavioural Category Codes were very similar, suggesting that group scores are comparable between DCM 7 and 8. Interviews with mappers and focus groups with staff teams suggested that DCM 8 was preferable to DCM 7th edition because of the clarification and simplification of codes; the addition of new codes relevant to person‐centred care; and the replacement of Positive Events with a more structured recording of Personal Enhancers.ConclusionsDCM 8 appears comparable with DCM 7th edition in terms of data produced and is well received by mappers and dementia care staff. Copyright © 2006 John Wiley & Sons, Ltd.
The association of neuroleptic sensitivity in Lewy body disease with a false positive clinical diagnosis of Creutzfeldt‐Jakob disease
Authors: Lemstra A.W. , Schoenmaker N. , Rozemuller‐Kwakkel A.J.M. , van Gool W.A. 
Published: September 2006

AbstractBackgroundDementia with Lewy bodies (DLB) and Creutzfeldt‐Jakob disease (CJD) share clinical features like cognitive decline, motor disturbances en psychiatric symptoms. Overlapping symptoms may cause physicians to mistake DLB for CJD.MethodsClinical data of 12 patients with autopsy‐confirmed DLB who had been clinically suspected to suffer from CJD were analysed to investigate possible clinical features which led to misdiagnosis.ResultsThere was an association in time between administering neuroleptics and rapid clinical deterioration in 8 out of 9 patients.ConclusionIt is suggested that the neuroleptic sensitivity in LBD fuelled the misdiagnosis of CJD in the presented series. Diagnostic confusion between CJD and DLB may have important clinical consequences and may lead to treatment restrictions. Copyright © 2006 John Wiley & Sons, Ltd.
Nutrient intake and psychological health in an elderly Chinese population
Authors: Woo J. , Lynn H. , Lau W. Y. , Leung J. , Lau E. , Wong S. Y. S. , Kwok T. 
Published: September 2006

AbstractBackgroundAssociations between nutrition and cognitive impairment, and nutrition and depression, have been observed. Elderly people are at risk of under nutrition, and also have higher prevalence of cognitive impairment and depression.ObjectiveTo examine the relationship between nutrient intake and psychological health in the elderly, adjusting for confounding factors.SubjectsThree thousand nine hundred and ninety‐ninemen and women aged 65 years and over living in the community, with approximately equal numbers in three age groups: 65–69, 70–74, 75+ years.MethodsDietary intake was assessed using a 7‐day food frequency questionnaire. Cognitive function was assessed by the cognitive part of the Community Screening Instrument for Dementia (CSID). Depression was assessed using the Geriatric Depression Scale (GDS). Information was also collected for confounding factors: demographics, educational level, socioeconomic status, medical history, smoking, alcohol intake, and physical activity. Logistic regression analyses were carried out to examine associations between lifestyle and dietary variables, and CSID and GDS, controlling for confounders.ResultsBoth CSID and GDS scores were associated with co‐morbidity, demographic and socioeconomic factors. Few associations between lifestyle factors and CSID score were observed. Dietary factors inversely associated with GDS score include total fat intake, vitamins A, B2, B3, C, fibre, and vegetables. In terms of nutrient density, iron and isoflavone intake were additional factors.ConclusionAssociation exists between intake of various nutrients and psychological health independent of other confounding factors in the elderly population. A follow‐up study of this cohort or interventional studies are needed to elucidate cause effect relationship. Copyright © 2006 John Wiley & Sons, Ltd.
Elderly suicide attempters: characteristics and outcome
Authors: Lebret Stéphane , Perret‐Vaille Estelle , Mulliez Aurélien , Gerbaud Laurent , Jalenques Isabelle 
Published: September 2006

AbstractPurposeWe made a descriptive survey to assess the outcome of elderly patients discharged from a hospital psychiatric service after a suicide attempt (rates of overall mortality and repeat attempts), to identify the factors that had a significant impact on their survival and to determine patient characteristics.MethodsFifty‐nine suicide attempters over 60 years of age admitted to hospital between 1993 and 2000 were included in the study. Their outcome was assessed by questioning their attending physicians over the telephone. We traced 51 of the 59 patients; 8 were lost to follow‐up. Statistical analysis (Log Rank tests, Cox model) was computed to determine which factors altered the overall survival and the survival without further attempt.The patients sociodemographic, medical and psychiatric characteristics were recorded from hospital patient files.ResultsElderly suicide attempters showed an increased mortality from suicide and natural causes and the risk of a repeat attempt increased in female patients with memory disorders. The factors altering survival were advanced age, pre‐existing physical disability, several co‐existing physical illnesses, severe physical consequences of the suicide attempt, history of psychiatric illness other than depression, memory disorders and one previous suicide attempt.The elderly suicide attempter was most likely to be a widowed woman suffering from social isolation, loneliness and depression.ConclusionElderly suicide attempters remained both physically and mentally vulnerable after their attempt. A repeat act represents a turning point in personal life progression which it is essential to detect. Copyright © 2006 John Wiley & Sons, Ltd.
Factors related to hospitalization in elderly manic patients with early and late‐onset bipolar disorder
Authors: Lehmann Susan W. , Rabins Peter V. 
Published: September 2006

AbstractObjectiveTo identify factors contributing to relapse and hospitalization in elderly patients with bipolar disorder.MethodRetrospective chart review surveyed consecutive patients over age 65 admitted to the Johns Hopkins Hospital for a manic episode over a five year period (n = 73). Factors precipitating index admission were compared in patients with early‐onset bipolar disorder (<or = age 45, n = 38) and late‐onset bipolar disorder (>age 45, n = 35).ResultsThe distribution of ages of onset of bipolar disorder was most consistent with a bimodal pattern with a cut‐point at age 45. Early‐onset patients were more likely to have been aggressive and threatening prior to admission (p = 0.014) compared to late‐onset patients and were more likely to have been brought to the emergency room on emergency petition for evaluation (p = 0.028). Early‐onset patients were also more likely to have been non‐adherent with prescribed psychiatric medication (p = 0.032).ConclusionsRelapse and rehospitalization were common among elderly manic patients with early‐onset and late‐onset bipolar disorder. Strategies which improve medication adherence are needed to help prevent recurring hospitalization. Copyright © 2006 John Wiley & Sons, Ltd.
Drug prescription in mild cognitive impairment: the physicians' perspective in Italy
Authors: Frisoni Giovanni B. , Canu Elisa , Geroldi Cristina , Zanetti Orazio , Zacchi Valeria 
Published: September 2006

AbstractObjectivesToday there are no data on the type of drugs prescribed to MCI patients nor the prevalence of their prescription. The aim of this study was to describe which drugs were prescribed in 2004 for cognitive and non cognitive disturbances of patients with MCI in a sizable group of Italian expert centers for the diagnosis and treatment of Alzheimer's disease.MethodsEighty‐eight of the 314 contacted UVAs (28%) agreed to take part to the present study. The physicians were surveyed with a structured questionnaire assessing questions related to prescription of drug therapy based on their subjective judgement.ResultsCholinesterase inhibitors are prescribed to 90% of patients with AD but, interestingly, to about one in four patients with MCI (27%). Gingko and nootropics are prescribed infrequently, but in MCI two to three times more often than in AD. About one in four (27%) and one in ten (9%) MCI patient are prescribed SSRIs and benzodiazepines, a proportion similar to that of AD (28% and 10%), while atypical and traditional neuroleptics are virtually never used in MCI patients. Vitamin E is prescribed to more than half of MCI (57%) and in about half as many AD patients (27%).ConclusionsThese data suggest that lacking approved or clearly effective drugs for cognitive symptoms, physicians respond with ‘analogy treatments’ and by increasing the prescription of ‘accessory drugs’. Non cognitive symptoms in MCI are managed virtually exclusively with SSRIs and benzodiazepines. Copyright © 2006 John Wiley & Sons, Ltd.
Quality of life measures for depressed and non‐depressed Chinese older people
Authors: Chan Sally Wai‐chi , Chien Wai‐tong , Thompson David R. , Chiu Helen F. K. , Lam Linda 
Published: September 2006

AbstractAimTo compare the perception of quality of life (QoL) between depressed and non‐depressed Chinese older people in Hong Kong and examined the factors that influence this perception.MethodsA cross‐sectional study was conducted with a convenience sample of 80 older people with a diagnosis of depression and 179 non‐depressed controls.ResultsThe depressed group had a lower rating in perceived QoL in all aspects than the non‐depressed group. Level of depression and functional abilities were predictors of quality of life ratings for the both groups and activities of daily living was the predictor of quality of life for the depressed group only. The study identified the subjective perception of QoL amongst depressed older people is significantly lower than that amongst non‐depressed older people. Depression affects the bio‐psychosocial status of Chinese older people. This study provides insight for healthcare professionals in planning innovative services to meet their health needs. Copyright © 2006 John Wiley & Sons, Ltd.
Doll use in care homes for people with dementia
Authors: James Ian Andrew , Mackenzie Lorna , Mukaetova‐Ladinska Elizabeta 
Published: September 2006

AbstractDolls and teddy bears were introduced into an Elderly Mentally Ill (EMI) home as part of a non‐pharmacological intervention. Thirteen residents from a population of 33 chose to use a doll and one chose a teddy bear. The impact of the toys was assessed on five domains over a 12‐week period and the findings were generally positive, which was consistent with previous observations (Mackenzie et al., in press). The investigation also attempted to determine whether staff were able to predict which residents would chose a toy. In terms of the dolls, out of the 16 residents predicted to use a doll, nine did so (56% accuracy). Despite the benefits outlined in this largely descriptive study, a number of problems were observed and some of these difficulties are outlined below. Copyright © 2006 John Wiley & Sons, Ltd.
Response inhibition and everyday memory complaints in older adult women
Authors: Potter Guy G. , Hartman Marilyn 
Published: September 2006

AbstractObjectiveTo explore the association of executive functions to the everyday memory complaints of healthy older adults.MethodsNinety‐nine community‐dwelling women aged 60 and above were administered a battery that included neuropsychological tests of executive functions and memory, along with self‐report measures of everyday memory complaints, depression, and anxiety.ResultsMultivariate regression analyses revealed that a measure of response inhibition (Stroop Color‐Word) accounted for unique variance in predicting memory complaints above and beyond measures of episodic memory, depression, and anxiety. Depression, however, accounted for the largest variance in memory complaints.ConclusionsHigher frequency of everyday memory complaints among older adults was associated with decreased response inhibition independent of episodic memory and affective state. Further research is needed to understand the interrelationships among these and other predictors of everyday memory complaints. Copyright © 2006 John Wiley & Sons, Ltd.
Differences in diagnostic subtypes among patients with late and early onset of a single depressive episode
Authors: Kessing Lars Vedel 
Published: September 2006

AbstractObjectiveIt is unclear whether patients with late onset and patients with early onset present with different subtypes of depression. The aim of the study was to compare the prevalence of subtypes of ICD‐10 single depressive episodes for patients with late onset (age >65 years) and patient with early onset (age ≤ 65 years) in a nationwide sample of all patients discharged from psychiatric in‐ or outpatient settings.MethodAll patients who got a diagnosis of a single depressive episode in a period from 1994–2002 at the end of the first outpatient treatment or at the first discharge from psychiatric hospitalisation ever in Denmark were identified in a nationwide register.ResultsIn total, 18.192 patients were given a diagnosis of a single depressive episode at the first outpatient contact and 8.396 patients were given a diagnosis of a single depressive episode at the first psychiatric hospitalisation ever. Patients with late onset were more often women, more often presented with a severe depressive episode and more often with psychosis than patients with early onset, in both inpatient and outpatient treatment settings. No differences were found between patients with late and patients with early onset in the prevalence of depression with or without melancholic symptoms–in either of the treatment settings.ConclusionsPatients with a late onset first depressive episode are more often women and are clinically characterised by more severe depressions and a higher prevalence of psychosis than patients with early onset. Copyright © 2006 John Wiley & Sons, Ltd.
Defining severe dementia with the Minimum Data Set
Authors: van der Steen Jenny T. , Volicer Ladislav , Gerritsen Debby L. , Kruse Robin L. , Ribbe Miel W. , Mehr David R. 
Published: September 2006

AbstractBackgroundAccurately defining severe dementia is important for care and prognosis, but is not explicitly included in the Minimum Data Set (MDS).ObjectiveTo define severe dementia using the MDS, we used data for nursing home residents with moderate to severe dementia.MethodsTwo cross‐sectional studies enrolled 175 residents; 89 residents from one US Veterans Affairs nursing home, and 86 residents from nine Dutch nursing homes. Measurements included the Cognitive Performance Scale (CPS; range: 0–6), activities of daily living (ADL) dependency, and the Bedford Alzheimer Nursing Severity‐Scale (BANS‐S; range: 7–28), a staging instrument specific for severe dementia.ResultsHalf of the residents received CPS scores of 5, and their BANS‐S scores varied widely. There was fair agreement (kappa = 0.36) between severe cognitive impairment as defined by the CPS (scores 5 and 6) and the BANS‐S (score 17 or higher). Addition of an ADL dependency requirement to the CPS definition improved agreement (kappa = 0.75). The observed patterns were similar but more obvious for US residents than for Dutch residents.ConclusionCognitively impaired residents comprise a heterogeneous group with a wide variety of function. Restriction with respect to ADL dependency allows for distinction between moderate and severe dementia. We propose the following MDS‐based definition of severe dementia: a CPS score of 5 or 6 with a minimum score of at least 10 points on the MDS ADL‐Short Form. Copyright © 2006 John Wiley & Sons, Ltd.
Patient versus informant reported quality of life in the earliest phases of Alzheimer's disease
Authors: Vogel Asmus , Mortensen Erik Lykke , Hasselbalch Steen G. , Andersen Birgitte B. , Waldemar Gunhild 
Published: September 2006

AbstractObjectivesThe study investigated if patient and informant reported Quality of Life (QoL) differed in early Alzheimer's disease (AD). In addition, we examined whether anosognosia had an impact on the agreement between patient and informant ratings of QoL and whether anosognosia, dementia severity, depression and behavioural symptoms were significantly correlated to QoL in early AD.MethodsFrom a prospective research program including newly referred patients (age >60 years and MMSE ≥ 20), 48 patients with very early AD were included. QoL was assessed using the QoL‐AD and EQ‐5D scales. Anosognosia was rated on a categorical scale by an examiner. MMSE, Geriatric Depression Scale, Danish Adult Reading Test and Frontal Behavioural Inventory were also administered.ResultsOn most QoL measures patients rated their QoL higher than their informants. Anosognosia was not associated with QoL but significantly with an inverse impact on the agreement between patient and informant ratings of QoL. Self‐reported QoL was significantly correlated to depression but not to age, dementia severity, behavioural symptoms or memory impairment. Informant ratings of QoL were significantly correlated to behavioural symptoms and informant ratings on the EQ‐5D Visual Analogue Scale were significantly correlated to patient reported depression.ConclusionPatients with early AD generally reported higher QoL than their informants. This disagreement was associated with the presence of anosognosia. Self‐reported QoL did not correlate with the MMSE score. Behavioural changes and depressive symptoms may be associated with low QoL. Copyright © 2006 John Wiley & Sons, Ltd.