bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discharge patterns from a psychogeriatric inpatient unit
Authors: Domken Mark , Bothwell Robert , McKeith Ian 
Published: December 2004

AbstractData were collected on inpatients admitted to one psychogeriatric unit in the Newcastle upon Tyne area, in the first 6 months of 1985, 1988 and 1991—a period which saw substantial reductions in the number of long‐term elderly care bed numbers in the statutory sector. Admissions to the unit increased by almost 50% over the 6 years while mean length of stay decreased from 12.4 to 9.4 weeks. Between 1988 and 1991 discharges into private sector care increased considerably with no evidence that this group differed in any way from those patients discharged into statutory care in terms of level of dependency or presence of behavioural problems. Patients with high dependency needs or behaviour problems which were difficult to manage tended to stay in hospital for much longer periods, possibly indicating a shortfall of suitable long‐stay facilities for this patient group.
Delirium during the course of clinically diagnosed Alzheimer's disease
Authors: Baker F. M. , Wiley Cynthia , Kokmen Emre , Chandra Vijav , Schoenberg Bruce S. 
Published: December 2004

AbstractA retrospective chart review was completed on the 122 cases of CDAD for the period of 1965–1970 identified from a longitudinal study of dementia at the Mayo Clinic. A psychiatrist assigned DSM‐III‐R diagnoses based upon the longitudinal description of symptoms detailed in the medical records of the Mayo Clinic hospitals, nursing home visit records and state hospital records.Thirty patients (25%) were found to have an episode of delirium (EOD) during their course of CDAD which occurred during inpatient admissions. Single EODs were found to occur within 2 years of the onset of CDAD, and multiple EODs within 3 years of the onset of CDAD. A psychiatric consultation was requested in only 14% of the sample (N = 17); 88% of these patients received diagnoses involving primary degenerative dementia of the Alzheimer's type, late onset. Psychopharmacology was the major management strategy (82% of patients with an EOD received medication) with the resolution of symptoms within 48 hours. At discharge, only two patients (7%) failed to completely clear the increased degree of confusion. Implications of these findings for the management of patients with CDAD and the management of EOD with the knowledge of the 1990s are discussed.
Disorganized sleep–wake schedule associated with neuroendocrine abnormalities in dementia. A clinical study
Authors: Björkstén Karin Sparring , Basun Hans , Wetterberg Lennart 
Published: December 2004

AbstractDemented patients were investigated by blood sampling at 10 occasions during a 24‐hour period. Serum levels of melatonin and cortisol were determined. One patient with probable vascular dementia had a severely disorganized sleep‐wake schedule and showed disturbed patterns of serum melatonin and cortisol. After withdrawal of alprenolol, substitution of a vitamin B12 deficiency and cataract surgery, the patient regained normal sleep habits and a normal circadian pattern of serum cortisol and melatonin. A patient with frontal lobe dementia and a disorganized sleep‐wake schedule showed a disturbed melatonin rhythm, unexpected cortisol peaks and a disability to suppress melatonin by light. Two Alzheimer patients with regular sleep habits had normal circadian patterns of serum melatonin and cortisol.
Augmentation strategies in geriatric depression
Authors: Flint Alastair J. 
Published: December 2004

AbstractApproximately 30–40% of elderly patients with major depression have inadequate response to an initial therapeutic trial of antidepressant medication. In these cases augmentation of the antidepressant has been recommended as one way of improving the rate of response. This article reviews the literature on augmentation strategies in treatment‐resistant geriatric depression. Successful augmentation with lithium, triiodothyronine, stimulants, carbamazepine, valproate and a tricyclic–serotonin reuptake inhibitor combination have been described. However, there have been no controlled trials and, with the exception of two open prospective studies of lithium potentiation, the literature consists entirely of case reports and retrospective case series. As a result, it is difficult to draw conclusions about the efficacy of these strategies in late life, especially since treatment failures seldom get reported. Side‐effects may limit the usefulness of some augmentation regimens in old age—up to 25% of patients treated with lithium or carbamazepine discontinued these medications because of adverse events. There is a need for controlled studies to better determine the clinical utility of augmentation strategies in physically well depressed elderly, as well as those with depression complicating medical illness, dementia and other neurological disorders.
Autopsy services for old age psychiatrists in england and wales: Can neuropathologists help?
Authors: Benbow Emyr W. , Reid Helen , Benbow Susan M. 
Published: December 2004

AbstractWe have previously shown that many old age psychiatrists are dissatisfied with their local autopsy services. Their most common complaint was the poor quality of central nervous system examinations carried out by general histopathologists, and so we sought to determine whether neuropathologists could carry out more autopsies on old age psychiatry patients. A postal questionnaire was used, and responses indicate that neuropathologists carry out an average of 8.8 autopsies on old age psychiatry patients each year, out of a mean total of 42.2 neuropathological autopsies, and examine an average of 28.3 other brains from old age psychiatry patients, out of a mean total of 109.3 cases. In general, respondents found autopsies on psychiatric and neurological patients much more interesting than autopsies on neurosurgical and forensic cases, but did not rate psychiatric autopsies as more important than any other kind of case. Most neuropathologists would wish to examine more brains from old age psychiatry patients, but would require more pathologists, more technicians or more resources before doing so. Old age psychiatrists who wish to obtain a better autopsy service may need to take the initiative.
The cognitive drug research computerized assessment system in the evaluation of early dementia‐is speed of the essence?
Authors: Nicholl Claire G. , Lynch Sean , Kelly Cornelius A. , White Linda , Simpson Pauline M. , Wesnes Keith A. , Pitt Brice M. N. 
Published: December 2004

AbstractThe cognitive drug research computerized assessment system (COGDRAS) was evaluated in 98 unselected Hammer‐smith Hospital Memory Clinic patients (mean age 64.9, range 28‐83 years). They were divided into five groups (worried well, depressed, demented, minimally cognitively impaired and other brain disorders) on clinical assessment, Mini Mental State Examination (MMSE) and Cambridge Cognitive Examination (CAMCOG) scores. All but one patient completed the computer package, confirming its acceptability. The results of the COGDRAS in the five groups were analysed blind to diagnosis. The performance of the demented group was significantly impaired in comparison with the worried well group, showing that the COGDRAS is valid in mild dementia (mean MMSE 21.5, mean CAMCOG 73.9). The depressed group tended to perform slightly less well than the worried well, and the ‘other’ group showed a wide range of scores consistent with its diversity. The minimally impaired had scores intermediate between the demented and worried well, but an interesting speed/accuracy tradeoff was seen‐patients appeared to maintain accuracy by taking longer to perform tasks. The heterogeneity of the minimally impaired group and the role of the measurement of task completion time in the diagnosis of early dementia are discussed.
Carer‐rated personality changes associated with senile dementia
Authors: Williams Rhoda , Briggs Roger , Coleman Peter 
Published: December 2004

AbstractAlthough adult personality traits have been shown to be stable with age, a recent study in the USA showed changes in a group of elderly people with memory disorders, as perceived by caregivers. The aim of this study was to replicate these findings in individuals suffering from senile dementia and to examine interactions with other emotional and physical stresses experienced by the carer. Thirty‐six subjects caring for an elderly person with dementia were visited twice in their own homes to assess the problems they had and how they were coping with them. NEO Personality Inventories were used to identify perceived personality changes. Individuals with senile dementia were regarded as becoming more neurotic, less extravert and less conscientious. These personality changes had more effect on carer morale than the physical burden of caring.
Citalopram‐lithium combination treatment of elderly depressed patients: A pilot study
Authors: Uehlinger Claude , Nil Rico , Amey Marlyse , Baumann Pierre , Dufour Henri 
Published: December 2004

AbstractFourteen elderly depressive patients (age 67‐88 yr), phenotyped with dextromethorphan and mephenytoin before and during the trial, were treated for 4 weeks with citalopram (final dose 20‐30 mg/day, except one patient 60 mg/day). The clinical state of the patients was recorded weekly using the Hamilton Depression Rating Scale, the CGI (psychopathology) scale, the VAS and the UKU scale for side‐effects. As assessed by the Hamilton Depression Rating Scale, nine patients improved by more than 50% and continued with their citalopram treatment. The treatment of the five non‐responders was then continued for another 2 weeks by addition of lithium (target plasma levels 0.4‐0.8 mmol/l) to the ongoing citalopram medication. After 1 week, one patient had to be withdrawn for non‐response, three were responders, while the fifth patient was a responder only after 2 weeks of lithium addition. Due to side‐effects, the lithium dose had to be decreased in one patient who had responded to the combination therapy. Plasma levels of citalopram were within 145‐459 nmol/l after 4 weeks of citalopram treatment. All patients were extensive metabolizers of dextromethorphan, and all but possibly one also of mephenytoin. After 4 weeks of citalopram, there was a highly significant correlation between the ratios of S/R‐mephenytoin in urine and citalopram/desmethylcitalopram in plasma, which suggests a common mechanism in the metabolism of these drugs. The preliminary finding that a citalopram‐Li combination therapy may be useful in elderly depressive patients resistant to citalopram alone needs to be replicated by a controlled double‐blind study.
The fragmentation of rest/activity cycles in Alzheimer's disease
Authors: Ghali Laura , Hopkins Robert W. , Rindlisbacher Peter 
Published: December 2004

AbstractClinicans caring for Alzheimer patients have observed that many have disruption in nocturnal sleep patterns. Despite their obvious clinical importance, little research has been conducted to investigate abnormal activity patterns in these patients. In this study, diurnal rest/activity patterns were examined using an electronic monitor with a movement sensor. Eighteen patients diagnosed with Alzheimer's disease were monitored for 48 consecutive hours each. Subject variables such as age, estiamted duration of illness and cognitive ratings were compared for degree of association with the movement data. Analyses indicated that an estimate of the duration of illness was superior to other variables in predicting the degree of change in activity rhythms. Specifically, the longer patients had suffered from Alzheimer's disease, the more disrupted their rest/activity patterns were. Patients who were in the late stages of Alzheimer's disease were less active and rested for longer than those in the earlier stages. In addition, circadian rhythmicity was reduced in the activity patterns of these patients. The present study confirms the findings of Hopkins and Rindlisbacher (1992) indicating that rest/activity patterns are dramatically altered as a result of Alzheimer's disease.
Success and failure in five case studies: Used of cued recall to ameliorate behaviour problems in senile dementia
Authors: Bird Michael , Alexopoulos Paula , Adamowicz Joanna 
Published: December 2004

AbstractFour patients suffering dementing illnesses and presenting management difficulties were taught the association between either a cue and a behaviour, or a cue and information affecting behaviour. On subsequently encountering the cue in the environment, targeted problem behaviour. On subsequently encourtering the cue in the environment, targeted problem behaviours diminished to manageable levels, were modified, or ceased. Problemes were: obsessive demands, inappropriate urinating and intrusive aggressive behaviour. The technique failed with a fifth patient, who shouted constantly. Theoretical and clinical aspects of the interventions and the teaching method (repeated retrieval trials) are discussed.
Social factors and psychiatric admission for senile dementia
Authors: Orrell Martin , Bebbington Paul 
Published: December 2004

AbstractThis study investigated the psychosocial and physical factors preceding psychiatric admission in 70 elderly patients suffering from senile dementia by comparing them with two control groups, 50 dementia sufferers in the community and 50 fit elderly people matched for age and sex. There was no overall excess of current physical ill‐health or disability in the dementia sufferers. Moreover, the dementia sufferers had more social contacts and better support from relatives and services than the fit elderly group. However, the dementia patients who lived with a carer had significantly more negative communication than those dementia controls living with carers. Negative communication may increase the risk of admission but may be attenuated by day centre support.
Social participation and cognitive functioning in older adults
Authors: Maria Carolien Hendrika Smits , van Rijsselt René Johannes Theresia , Jonker Cees , Deeg Dorly Joan Hardy 
Published: December 2004

AbstractThe association between aspects of social participation and components of cognitive functioning and the ability of these aspects to predict cognitive performance was studied in an age and gender stratified sample of 116 individuals aged 55‐89 years in the Netherlands. Measures of social participation included questionnaires on societal participation, sociocultural activities and media use. Cognitive functioning was measured by tests of fluid intelligence, processing speed, word learning and recall, and everyday memory. All aspects of social participation showed significant bivariate correlations with all components of cognitive functioning. Independent of age, gender, education and functional limitations, societal participation and sociocultural activities contributed significantly to the prediction of processing speed and of delayed recall. Tendencies of independent association were apparent between both societal participation and sociocultural activities and word learning. No aspect of social participation independently predicted fluid intelligence or everyday memory. The evidence suggests independent associations between social participation characterized by an organizational setting and high level of activity, and basic components of cognitive functioning, such as information‐processing speed and measures of learning and delayed recall. Further research needs to clarify the process underlying the causal relation between cognitive functioning and forms of participation.
The botany survey: A longitudinal study of depression and cognitive impairment in an elderly population
Authors: Snowdon John , Lane Fred 
Published: December 2004

AbstractAn 8‐year‐long longitudinal study of elderly people in Botany (Sydney) has provided data on the prevalence, incidence and outcome of cognitive impairment and depression in this population. In 1985, a random sample of 146 persons aged 65 years or more, living in their own homes, were assessed using the Brief Assessment Schedule, depression ratings and cognitive tests. Follow‐up interviews were conducted after 2, 4, 6 and 8 years. Data from separate hostel and nursing home studies were used when estimating prevalence rates. The estimated prevalence and annual incidence of definite dementia in Botany were, respectively, 14% (3.5% severe) and 2.5%. Among elderly people living at home the prevalence of definite dementia was 11%; 23% of our community sample suffered dementia during the 8 years. The prevalence and minimum annual incidence of depressive disorders were, respectively, 12.5% and 2.0%. Among those living at home the prevalence was 12.3%. Dementia was associated with a high mortality rate, but the apparently increased mortality of depressed subjects did not reach significance, probably because numbers were relatively small; a high proportion of the deceased had comorbid cognitive impairment. Some depressions eventually remitted.
A hindi version of the MMSE: The development of a cognitive screening instrument for a largely illiterate rural elderly population in india
Authors: Ganguli Mary , Ratcliff Graham , Chandra Vijay , Sharma Sujatha , Gilby Joanne , Pandav Rajesh , Belle Steven , Ryan Christopher , Baker Carol , Seaberg Eric , Dekosky Steven 
Published: December 2004

AbstractThe Indo‐US Cross‐National Dementia Epidemiology Study seeks to compare two rural populations, in the US and India: the Monongahela Valley, a rural community of relatively low socioeconomic status in southwestern Pennsylvania (USA), and Ballabgarh, a rural community near New Delhi in North India. Of Particular interest is the fact that the Ballabgarh elderly population is exclusively Hindi‐speaking, has little or no education and is largely illiterate, rendering its cognitive screening a particular challenge. In this article we report methods and preliminary data on the development of a Hindi cognitive screening instrument suitable for the Ballabgarh elderly population. We use as an example our Hindi adaptation of the Mini‐Mental State Examination (MMSE), a widely used global cognitive screening scale. Systematic, item‐by‐item, empirically based test development has shown that effective modifications can be made to existing tests that require reading and writing; and that culturally sensitive modifications can be made to render the test meaningful and relevant while still tapping the appropriate cognitive domains. Certain cognitive functions, particularly orientation to time, remain difficult to test adequately in this type of population. In Ballabgarh, as in the Monongahela Valley, educated individuals obtain higher test scores. Implications for dementia screening are discussed, including those relevant to the hypothesis that low education predisposes to dementia.
Antidepressant therapeutic effect of mianserin‐induced generalized tonic‐clonic seizure in an elderly patient
Authors: Rosenthal Michal , Schwartz Sima , Shapira Edy , Mester Roberto 
Published: December 2004

AbstractGeneralized tonic‐clinic seizures may appear as a side‐effect of all antidepressant drugs, including mianserin. We present here a case of an 83‐year‐old woman whose major depressive episode (superimposed on mild dementia) completely resolved following a generalized tonic‐clonic seizure. The improvement, which was maintained for 3 months, may be attributable to the drug‐induced single convulsion. It would be of interest to know whether other psychiatrists have had similar experiences concerning an immediate antidepressant effect to a single tonic‐clonic seizure (drug‐induced or provoked by electroconvulsive therapy). If a subgroup of patients responsive to single generalized tonic‐clonic seizure were to exist (especially among elderly patients), it would allow them to receive a minimal number of electroconvulsive therapy (ECT) sessions, decreasing the probability of the appearance of ECT side‐effects.
Cerebral blood flow changes in normal aging: Spect measurements
Authors: Swartz J. Randolph , Lesser Ira M. , Boone Kyle B. , Miller Bruce L. , Mena Ismael 
Published: December 2004

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

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

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