bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical diagnosis of presenile Alzheimer's disease: A novel approach
Authors: McGonigal Gerard , Thomas Brenda , McQuade Cecilia , Whalley Lawrence J. 
Published: December 2004

AbstractA national retrospective survey of hospital records was used to select those patients with presenile dementia who had undergone neuropathological examination. The National Institute of Neurological and Communicative Disorders and the Alzheimer's Disease and Related Disorders Association (NINCDS–ADRDA) clinical criteria for probable Alzheimer's disease and a Hachinski score were applied to each record before the neuropathological diagnosis was known. A discriminant analysis, which entered the criteria as variables, was performed. The diagnostic accuracy of the clinical criteria was compared before and after discriminant analysis. One thousand six hundred and seventy‐one records were scrutinised of which 61 patients had undergone neuropathological examination. NINCDS–ADRDA criteria had a diagnostic accuracy of 72% (specificity 88%, sensitivity 61%) compared to 77% (specificity 80%, sensitivity 75%) after analysis. NINCDS–ADRDA criteria together with the Hachinski score had an accuracy of 72% (specificity 61%, sensitivity 88%) compared to 83.6% (specificity 76%, sensitivity 89%) after analysis. Variables of highest discriminating value were the Hachinski score, presence of coexistent neurological disease and presence of coexistent systemic disease. The results highlight limitations of current clinical criteria used to diagnose Alzheimer's disease and suggest that substantial improvements are possible.
Short screening tests for dementia in the elderly population. II. The combined use of more than one test
Authors: Hooijer C. , Dinkgreve M. , Jonker C. , Kay D. W. K. 
Published: December 2004

AbstractIn the present report, the effects of combining two or more of four short screening tests for dementia in the elderly population were studied using GMS‐AGECAT organic levels as the criterion. Both the combined cut‐off scores and the summed test scores appeared to have clear advantages over the use of one test for the efficacy of case detection and for the comparability of studies. Costs and benefits of this procedure are discussed. In population‐based studies the addition of another screening test to the MMSE is recommended.
The effects of tacrine on regional cerebral blood flow in Alzheimer's disease
Authors: O'Brien John T. , Syed Ghulam M. S. , Levy Raymond 
Published: December 2004

AbstractRegional cerebral blood flow (rCBF) was studied in nine patients with Alzheimer's disease before and after treatment with tacrine. A small but significant improvement in cognitive functioning on the drug was not accompanied by significant changes in rCBF for the group as a whole. However, when the analysis was repeated excluding the only patient who showed no clinical response to the drug a significant increase in rCBF was seen to the right posterior temporal area. This preliminary study shows that some caution is necessary when interpreting studies of rCBF as changes in cognitive functioning may not always be accompanied by parallel changes in rCBF. Separate analysis of drug responders and non‐responders may be a fruitful area for further research.
Neuroimaging and the differential diagnosis of early dementia: Quantitative CT scan analysis in patients attending a memory clinic
Authors: Spanó A. , Förstl H. , Almeida O. P. , Levy R. 
Published: December 2004

AbstractSeventy‐eight consecutive patients who attended a ‘memory clinic’ underwent a standardized clinical examination including extensive laboratory tests and cranial computed tomography (CT). This brief report evaluates the contribution of quantitative CT scan analysis to the differential diagnosis of early dementia syndromes. Vascular changes were readily identified in 13 patients with a clinical history and findings compatible with vascular dementia. Enlargement of the anterior and Sylvian fissures and of the third and lateral ventricles was significantly more severe in a group of 29 patients diagnosed as Alzheimer's disease than in 36 ‘memory complainers’ with milder cognitive impairment or in 10 age‐matched non‐demented controls. Quantitative CT scan analysis alone permitted a correct diagnositc distinction between ‘memory complainers’ and patients with Alzheimer's disease in 83% of the cases, but led to an only modest improvement of the correct discrimination achieved by cognitive testing. Our results indicate that CT scans may aid the differentiation of ealry dementing conditions.
Late life psychosis
Authors: Lacro Jonathan P. , Harris M. Jackuelyn , Jeste Dilip V. 
Published: December 2004

AbstractPsychoses in late life are serious psychiatric disorders. They include schizophrenia (both late onset schizophrenic patients and the more prevalent early onset schizophrenic patients living into middle and old age), delusional disorder, psychosis in patients with dementia, psychosis in patients with depression, and miscellaneous psychoses. This article reviews some of the more recent and interesting findings in late life psychoses. A need for further research is stressed.
Clinical psychopharmacology research in geriatrics: An agenda for research
Authors: Schneider Lon S. , Martinez Rick A. , Lebowitz Barry D. 
Published: December 2004

AbstractThe two main areas of geriatric clinical psychopharmacology research, depression and dementia, are reviewed. The issues for depression research include pharmacokinetics in the geriatric population and the relationship to efficacy and side‐effects; the treatment of the medically ill and the very old; and maintenance and continuation treatments. In particular, the recommendations from the recently convened NIH Consensus Development Conference for the Diagnosis and Treatment of Depression in Late Life are discussed. The issues in dementia research include effective treatment of behavioral symptoms as well as severe and mild cognitive impairment; the development of better cholinesterase inhibitors; the application of other drugs; and the use of appropriate clinical trials methodology.
Prevalence and recognition rates of psychiatric disorder in the elderly clients of a community care service
Authors: Banerjee Sube 
Published: December 2004

AbstractOne hundred and sixty‐nine people over the age of 65 receiving home care services in Lewisham were interviewed using the Geriatric Mental State (A) (GMS(A)) and diagnostic output was obtained using AGECAT. The prevalence of psychiatric disorder in this group is reported and is compared with that found in community surveys which have used the GMS/AGECAT package. Of note is the 26.0% prevalence rate of cases of depression. The prevalence rate of AGECAT ‘depressive psychosis’ was found to be 13.6%, which was significantly higher than expected. Measures of agreement between AGECAT diagnostic cases and assessments made by home care staff are presented—‘kappa’ values and negative predictive values are higher for organic cases than for cases of depression. These ‘recognition’ rates are compared with reported recognition rates of psychiatric disorder in the elderly by health care professionals. Suggestions for further research are made so that the stated aims of the White Paper Caring for People can be achieved.
Cognitive screening of nursing home residents: Factor structure of the modified mini‐mental state (3MS) examination
Authors: Abraham Ivo L. , Manning Carol A. , Boyd Mary R. , Neese Jane B. , Newman Maureen C. , Plowfield Lisa Ann , Reel Sally J. 
Published: December 2004

AbstractWe examined factor structures of the Modified Mini‐Mental State Examination in a sample of nursing home residents (N=892; observation‐to‐variable ratio 59.5:1). Using principal components analysis and orthogonal equamax rotation, a five‐factor structure was derived. This solution, which explained 58.9% of the variance, consisted of the following factors: psychomotor skills, memory, identification and association, orientation, and concentration and calculation. This factor solution shows that, notwithstanding previous claims to the contrary, cognitive screening tests may be able to make stable and independent distinctions between psychomotor and perceptual‐organizational processes. The factors derived map well onto commonly recognized dimensions of neurocognitive ability. The proposed five‐factor solution offers a stable, intuitively sound, and statistically supported framework for differentiation of cognitive screening data into independent dimensions.
Factors related to coping with physical and instrumental activities of daily living among people born in 1904–1923
Authors: Laukkanen P. , Kauppinen M. , Era P. , Heikkinen E. 
Published: December 2004

AbstractFunctional ability is affected by a number of different factors, including biological ageing, illness, and living environment. This study was concerned with the connections of functional ability with mood and cognitive capacity in elderly individuals. It forms part of a cross‐sectional study which was carried out in 1988, involving two random samples of 800 non‐institutionalized persons born in 1904–1913 and 1914–1923. Functional ability tests included 18 questions; eight concerned coping with physical activities of daily living (PADL) and 10 instrumental activities of daily living (IADL). Depressive symptoms and cognitive capacity were examined by tests. In addition, there was a set of questions concerning health status and socioeconomic situation. Regression models (LISREL) were used to identify factors associated with PADL and IADL activities. In the younger age group, 68% of the men and 65% of the women had no difficulty in coping with PADL activities. The figures for the older group were 58% and 37%, respectively. Difficulties were reported more frequently with IADL activities. In the older age group 17% of the men and 10% of the women coped with no difficulty. In all activities difficulties tended to increase with age, and more so among women than men. The explanatory factors that emerged from the regression models as most significant were the number of chronic illnesses, the number of depressive symptoms and cognitive capacity.
Stress on relative caregivers of dementia sufferers, and predictors of the breakdown of community care
Authors: Jerrom Bill , Mian Ihsan , Rukanyake Nemal G. , Prothero David 
Published: December 2004

AbstractThe stress upon the principal relative caregivers of a series of dementia sufferers attending an assessment day hospital was studied. The main variables influencing stress levels were the caregiver's own health self‐rating and a measure of behaviour and mood disturbance in the patient. Predictors of the breakdown of community care over a 1‐year follow‐up period were studied. At 12 months caregiver's ‘caseness’ on the GHQ was a highly significant predictor. Clinical work with dementia sufferers in the community should include an assessment of the health and psychological status of the caregiver. Future research should focus upon evaluating specifically targeted interventions aimed at reducing stress in caregivers.
Determinants of disability in alzheimer's disease
Authors: Zanetti Orazio , Bianchetti Angelo , Frisoni Giovanni B. , Rozzini Renzo , Trabucchi Marco 
Published: December 2004

AbstractThe aim of the study is to evaluate risk factors of disability in a population of 64 patients affected by Alzheimer's disease. The subjects were consecutively recruited at the day hospital service of an Alzheimer's dementia care unit. The associations between activities of daily living and age, cognitive status, affective status, cognitive symptoms duration and number of diseases were evaluated within a multidimensional assessment programme. Cognitive performance, as detected by the Mini‐Mental Status Examination, was the main independent predictor of disability; other independent predictors of disability were age and cognitive disease duration. Number of diseases—physical and mental–and self‐rated depression scores were not independently associated with disability. It is concluded that, in a population of Alzheimer's patients, cognitive impairment has a high impact on the aetiology of disability, but other variables such as age and disease duration should be taken into account. It is also suggested that cognitive performance is the most important indicator of performance in activities of daily living.
Comment. ‘I don’t feel old': The significance of the search for meaning in later life
Authors: Thompson Paul 
Published: December 2004

AbstractA critique of the study of ageing by social scientists is provided in this article, on the basis of the comparative neglect of life history studies across the whole lifespan. It points to the skewed nature of studies reported in the literature. As a corrective, results from a UK life history based study are presented. It focuses on work, leisure, grandparenting, and intimate relationships between adults, leading to conclusions about the factors determining later life experiences and self‐perceptions of the meaning of old age.
Suicide in the elderly in Austria
Authors: Etzersdorfer Elmar , Fischer Peter 
Published: December 2004

AbstractIn most countries men and women have the highest suicide rates in age groups over 60 years. We investigated suicide rates for the elderly in Austria, a country with one of the highest suicide rates in the world, for the period 1980–1991, using data from the Federal Statistical Division. Suicide rates remained stable over the last decade at a very high level. The mean rate for men was 85.2, for women 28.6/100 000. In men and women rates rise with age. The mean rate of men rises from 51.2 (60–64 years) to 117.3/100 000 (over 85 years); in women there is an increase from 21.4 (60–64 years) to 32.8/100 000 (over 85 years). We did not confirm findings in other countries, where suicide rates have increased in recent years.
Progression in alzheimer's disease: Sequencing of neuropsychological decline
Authors: Almkvist Ove , Bäckman Lars 
Published: December 2004

AbstractThe progression of cognitive and motor functions in Alzheimer's disease (AD) patients and healthy aged individuals was studied. For the healthy aged, the progress was negligible during a 2‐year period. In the AD patients, there was a marked progression in all cognitive tests, but only a slight progression in the finger motor tests. Progression rate varied substantially across functions; the most rapid progression was seen in psychomotor speed, whereas the slowest was seen in episodic memory. The onset of decline was estimated to have occurred first in episodic memory, then in psychomotor speed, semantic memory, and visuospatial functions; finally and most recently, decline was estimated to have occurred in primary memory. The overall data pattern suggests that the onset as well as the rate of progression varies across cognitive functions, and that there may be a time‐ordered sequence of decline of neuropsychological functions in AD that parallels the trajectory of neuropathological changes in this disease.
The quality of interactions schedule (QUIS): Development, reliability and use in the evaluation of two domus units
Authors: Dean Rachel , Proudfoot Roger , Lindesay James 
Published: December 2004

AbstractThe Quality of Interactions Schedule (QUIS) was developed as part of the prospective evaluation of two residential domus units for elderly people with severe mental illnesses. QUIS is an observational strategy in which social interactions between residents and care staff are coded as positive social, positive care, neutral, negative protective or negative restrictive. The interrater reliabilities of both the observational technique and the category codings were good. In the domus evaluation, QUIS demonstrated that the number and quality of interactions were significantly improved in both domuses compared to a baseline hospital ward at 3 months, 6 months and 12 months follow‐up. In particular, the number of negative interactions observed fell to almost zero in the domuses at 12 months.
Behavioural symptoms in the institutionalized elderly—relationship to dementia
Authors: Nösman Birgitta , Bucht Gösta , Eriksson Sture , Sandman P. O. 
Published: December 2004

AbstractA proportion of patients in long‐term care institutions have behavioural symptoms that increase the physical and psychiatric workload of those caring for them. We performed a cross‐sectional study in order to assess the prevalence of behavioural symptoms in patients in various types of long‐stay institutions. In addition, we studied behavioural patterns to find predictors for behavioural symptoms. Prevalence and pattern of behavioural symptoms were studied in 1350 patients in the long‐stay institutions in the county of Umeå using Gottfries and Gottfries Psychogeriatric and Sandman‐Adolfsson's Multi‐Dimensional Dementia Assessment Scales. The patients were in a psychogeriatric unit, a somatic long‐stay unit, eight nursing homes and 15 homes for the aged with a total number of 1403 beds. Behavioural symptoms were found in 65% of the patients and were classified into six syndromes: escape, aggression, restlessness, wandering, regression and verbally disruptive behaviour.
Psychiatric morbidity among ‘ABLE’ residents of part III homes
Authors: Stout Ian , Wilkin David , Jolley David J. 
Published: December 2004

AbstractOne hundred and thirty residents of 11 Part III homes who had been in care for a year or more and had no cognitive impairment as assessed by the Crichton Royal Behavioural Rating Scale were investigated using the Clinical Interview Schedule, the 10‐question Mental Test Score and standardized schedules for aphasia and parietal lobe function. Thirty per cent showed signs of early dementia; mild to moderate neurotic symptoms were common among the remainder. Ten per cent had longstanding impairment of intellect or personality or were schizophrenic. Less than 15% warranted a diagnosis of neuritic depression or anxiety. Most of this psychopathology was regarded as ‘normal’ by senior staff. Relatively well‐preserved ‘clients’ presenting as ‘in need of care’ should receive particularly careful attention when formal assessment is reintroduced as a requirement before placement into rest homes at public expense. Those failing because of mild/moderate dementia are likely to benefit from admission while others may find life in care frustrating and depressing.
Electroconvulsive therapy in elderly patients with intracranial tumor: A case series
Authors: Holroyd Suzanne 
Published: December 2004

AbstractFive cases of depressed elderly patients with intracranial tumors treated with electroconvulsive therapy (ECT) are reported. None had adverse reactions to ECT and all had a positive response. The largest tumor was 4 cm in diameter. No case had evidence of increased intracranial pressure or mass effect. Three tumors were meningiomas, the other two were an acoustic neuroma and a pituitary adenoma. Given that increased use of neuroimaging techniques may result in discovery of incidental intracranial tumors in the depressed elderly prior to ECT, this report suggests that ECT in such patients may be administered safely.
Crisis intervention in psychogeriatrics: A round‐the‐clock commitment?
Authors: Doyle Harry , Varian John 
Published: December 2004

AbstractThe purpose of the study was to ascertain if comparable results could be obtained with a crisis intervention service operating during normal working hours as with a round‐the‐clock service. A follow‐up study, over a period of 3 years, was conducted on a cohort of 70 patients aged 65 years and over who were referred urgently to a Crisis Intervention Team over a 6‐month period. This team operated on a 9–5 basis. Outcome under several headings was compared with outcome in a previously reported 2‐year follow‐up study of a crisis intervention service which operated on a 24 hr basis. This group had comparable age and sex distribution, and similar proportions living alone at referral. Diagnostic groupings were similar and in both groups similar percentages of those referred were admitted (31% of 9–5 group vs 29% other). Notable differences were a greater referral rate in the 24 hr group and significantly greater numbers living in residential accommodation in the 9–5 group. Over the follow‐up period 9% of the 9–5 group were admitted vs 5% other. There was a greater use of community services by the 24 hr group. Mortality was almost identical in both groups. The finding that on many outcome criteria results were as impressive in the service operating during normal working hours as in the round‐the‐clock service has important service implications. However, caution is needed in interpreting the results due to the difficulties of comparing two geographically separate services with varied demographic differences. Suggestions for further analysis of models of service delivery are made.
Neuropsychiatric lupus erythematosus and the elderly
Authors: Dennis Michael 
Published: December 2004

AbstractRecent research suggests systemic lupus erythematosus (SLE) is more common in the elderly than previously thought. Neuropsychiatric disorder occurs in the majority of patients at some time during the course of the illness. Frequently neuropsychiatric features occur early, and may precede other typical features of multisystem disease by some years. An organic brain syndrome is the most frequently encountered neuropsychiatric manifestation of SLE. It is important that cases presenting to elderly services are recognized, as organic brain disorders resulting from SLE are potentially treatable.
Tourette syndrome in the elderly
Authors: Hartman Jennifer Anne , Yuvarajan Rasiah 
Published: December 2004

AbstractAn 82‐year‐old housewife presented with motor and phonic tics and coprolalia. These had developed in the months following an acute confusional state associated with posterior neck pain 10 years previously. Neurological examination, including MRI scan, was otherwise normal. The index illness was presumed to be encephalitis lethargica.
Quasi‐experimental evaluation of an educational model for dementia caregivers
Authors: Brodaty Henry , Roberts Kate , Peters Karin 
Published: December 2004

AbstractDementia caregivers are known to be distressed and may be helped by psychoeducational interventions. We investigated the effectiveness of one model of intervention comprising a structured package of six sessions of training, focusing on education, stress management and problem behaviour management in a group setting. Three groups of caregivers were compared‐those who had completed (N= 33) or partially completed (N= 22) training and a control group (N= 26)‐on measures of psychological stress, burden, satisfaction with life, well‐being and knowledge. There were no significant differences in outcome between the three groups. We conclude that, with methodological qualifications, this quasi‐experimental study of one model of training was not empirically effective. Interventions for caregivers should be tailored to individual needs from a range of techniques encompassing psychological and practical strategies.