bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric diagnoses made by the agecat system in residents of local authority homes for the elderly: Outcome and diagnostic stability after four years
Authors: Ames David 
Published: December 2004

AbstractEighty‐six residents of 12 local authority homes for the elderly were interviewed with the Geriatric Mental State (GMS) in 1985/6 after having been classed as depressed by a screening interview. The data so gathered were analysed by the computerized diagnostic program AGECAT in order to derive psychiatric diagnoses for these residents. All were traced after four years; 61 were dead. The 25 survivors were reinterviewed and given a second AGECAT diagnosis. In 1985/6 70 of the 86 examined were ‘diagnostic cases’ of psychiatric disorder. After four years 22 of the 25 survivors were classed as diagnostic cases. AGECAT diagnoses of organic psychosis were stable over four years within this population though the majority of subjects so diagnosed died within four years. Cases of depression had a more varied prognosis, with death, continunce as cases of depression or progression to organic psychosis being the most common outcomes. Recovery from any class of AGECAT disorder was an uncommon event.
Screening scales for dementia: Toward reconciliation of conflicting cross‐cultural findings
Authors: Gurland Barry J. , Wilder David E. , Cross Peter , Teresi Jeanne , Barrett Virginia W. 
Published: December 2004

AbstractA compendium instrument of five widely used dementia screening scales was applied to 550 subjects 65 years and older. Black, Hispanic and white groups were approximately equal in size. Recruitment was designed to produce an uneven and unknown mix of dementia cases and normals among these groups. A complex challenge to assessment and classification was thus contrived, approximating key aspects of the problem posed to cross‐cultural epidemiology. The published scoring systems of these dementia screens gave drastically conflicting results for absolute and culturally relative rates of cognitive impairment. The conflicts between scales appeared to be largely due to the varying sensitivities of the scales and, to a lesser extent, sociocultural bias. The conflicts were partially resolved through adjustments of the scale cut points.
Medication used by elderly people at home: Changes over 10 years
Authors: Malcolm M. T. 
Published: December 2004

AbstractThe medication actually taken by 223 elderly people referred for a psychiatric opinion and seen in their own residence was compared with that reported in a very similar study made 10 years earlier. Though the average age had increased by two and a half years and there had been a great increase in those living in care homes (where more medication was used), the average consumption of medications fell. Numbers of patients on no medication doubled. Drugs used for physical illnesses and depression were unchanged. There was a marked fall in use of benzodiazepines, especially by day, and chlormethiazole. A move to shorter acting benzodiazepines was recorded. Suggested reasons for this change include: availability of alternative management techniques and therapies, education of prescribers, threats of litigation and a change in attitude of patients, relatives and staff.
Changes in elderly suicides in the USA and the developed world 1974–87: Comparison with current homicide
Authors: Pritchard Colin 
Published: December 2004

AbstractBetween 1974 and 1987 there were increases overall in male suicide rates in the USA, with the greatest increases among elderly men. While female suicide levels overall fell in the USA, elderly female suicide rates failed to show the same improvement. Compared with the rest of the western world, suicide rates for elderly people in the USA were among the worst. Suicide was far more prevalent than homicide, but this is not reflected in the media, where homicide is given a high profile but where there is relative silence surrounding suicide among elderly people.
Interaction between narcolepsy—cataplexy and bipolar mood disorder in an elderly woman
Authors: Meats Philip , Hellewell Jonathan , Jolley David 
Published: December 2004

AbstractAn elderly woman who presented with a manic depressive psychosis and the narcolepsy‐cataplexy syndrome is described. Cataplexy occurred only during hypomania. Other narcoleptic symptoms were more evident during depression. We are not aware of previous reports of an interaction between these two conditions, which is of considerable interest.
The treatment of late age onset psychoses with electroconvulsive therapy
Authors: Figiel Gary S. , Botteron Kelly , Zorumski Charles F. , Jarvis Michael R. , Doraiswamy Murali , Krishnan Ranga 
Published: December 2004

AbstractThe authors describe the clinical course and the brain imaging findings of six patients with late age onset psychoses who were treated with electroconvulsive therapy (ECT). In all five patients who failed to respond to ECT, one or more structural brain changes (lateral ventricular enlargement and/or subcortical structural changes) were observed. In addition, all six patients developed an interictal ECT‐induced delirium. Consistent with previous ECT‐induced delirium studies, caudate hyperintensities were present in the three patients who received brain MRI scans. The potential clinical correlates of structural brain changes in LAOP patients will be described, along with proposed areas of future research.
Late‐life paranoia: Possible association with early trauma and infertility
Authors: Gurian Bennett S. , Wexler Debra , Baker Errol H. 
Published: December 2004

AbstractWe have collected data on 39 persons with late‐life onset of paranoid symptoms, all but two of whom are women. We identified a subset of nine patients that met the criteria for delusional disorder. This group differed significantly from both demented and long‐term schizophrenic patients on a number of variables. There was only one live birth among these nine women; more than half were refugees or holocaust survivors; there was an absence of a predicted sensory loss; and the manifestation of the paranoia was qualitatively different. Several issues are discussed: there is a late‐life delusional state that is neither schizophrenia nor dementia; the paranoia in these delusionally disordered patients cannot be accounted for exclusively by the social isolation hypothesis; there is an interaction among early trauma, the absence of children, and the appearance of paranoid ideation late in life.
Who does what for whom? Audit and dynamics of an acute psychogeriatric assessment unit
Authors: Rands Gianetta 
Published: December 2004

AbstractAn acute psychogeriatric inpatient assessment unit was studied over a six‐month period. Information collected retrospectively from case notes included details of each patient's circumstances, support, diagnosis and treatment. Input data from each of the professionals in the multidisciplinary team were collected and patient outcome was judged by a professional blind to the nature of this project. Characteristics of this patient group are summarized. The occupational therapist, psychologist and social worker concentrated their time on the same set of patients who were not those judged most demanding by the nursing staff. The OT concentrated on patients with a good outcome and the social worker tended to see patients with long admissions.The results are discussed for their relevance to allocation of resources, multidisciplinary team functioning, and clinical audit.
Diagnosis of dementia. II—Diagnostic methods: A survey of current consultant practice and review of the literature
Authors: Smith C. W. , Byrne E. J. , Arie T. , Lilley J. M. 
Published: December 2004

AbstractInaccuracy in the diagnosis of the dementia syndrome is widely reported. In a postal survey which asked hospital specialists about their use of diagnostic criteria and explored their knowledge of the aetiology of the syndrome, clear differences between research findings and clinical practice emerged. Clinicians are unlikely to use research diagnostic criteria and about half of the respondents consider the results of investigations to be essential in the diagnosis of the dementia syndrome. The frequency of contact with new patients with the dementia syndrome influenced some aspects of knowledge of its aetiology.
The diagnosis of depression in patients with dementia: Use of the cambridge mental disorders of the elderly examination (CAMDEX)
Authors: Logie Susan A. , Murphy J. Barry , Brooks D. Neil , Wylie Shona , Barron Elizabeth T. , McCulloch James 
Published: December 2004

AbstractThe prevalence of depression in 80 well‐diagnosed demented patients was examined using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) based on information from patients, caregivers and professionals. The overall prevalence of DSM‐III‐R major depressive illness was 5%, but the identification of depressed patients and the prevalence rate varied with the source of information used. The symptom profiles of the patients were examined in more detail. The significance of these findings and the use of operational diagnostic criteria in the investigation of coexistent depression and dementia are discussed.
Case report: Frontal lobe tumor presenting as late onset depression
Authors: Goodman Adam J. , Kumar Anand 
Published: December 2004

AbstractA 64‐year‐old female with no past psychiatric history presented with a two‐month history of depressive symptoms. She met DSM‐III‐R criteria for major depressive episode with melancholia. Physical exam revealed a left‐sided Horner's syndrome, and MRI scan of the brain revealed large bilateral frontal lobe masses that were neurologically silent. This case demonstrates that intracranial tumors can present as late onset depression without significant accompanying neurologic deficits.
Death in dementia: A study of causes of death in dementia patients and their spouses
Authors: Ryan D. H. 
Published: December 2004

AbstractThe certified cause of death in 455 married dementia patients admitted to a psychogeriatric unit between 1971 and 1986 was studied. The cause of death in 154 spouses of dementia patients who died within the study period was also recorded, and analysed for concordance between patients and spouses. The pattern of mortality was similar for male and female patients. Bronchoopneumonia was the most common certified cause of death (40%) in the patient group, and ‘non‐specific’ causes of death accounted for 63% of mortality. The pattern of mortality was significantly different to that in the general population, and non‐specific deaths were twice as common in the patient group. Comparison with previous studies shows that the pattern of mortality in dementia patients has remained relatively unchanged over the past 50 years despite alterations in medical practice. Common cause of death between patient and spouse was analysed and no evidence of significant concordance was found, but cause of death among spouses tended to follow the pattern of mortality in patients and was significantly different to that found in the general population. Possible explanations for the unchanging pattern of mortality in dementia are considered, and the case for an intrinsic mechanism of terminal weight loss and decline is discussed.
Eating disorders in later life: A review
Authors: Cosford Paul , Arnold Elaine 
Published: December 2004

AbstractEating disorders are considered to primarily afflict young people to the exclusion of the elderly. However, reports in the recent literature have challenged this view, with both anorexia nervosa and bulimia nervosa being described in later life. Although in some reports the diagnosis appears doubtful, the majority appear to demonstrate the classical features of these condtions. They have many similarities with younger sufferers, including clinical features, maladaptive psychological functioning, and a close relationship with other psychiatric conditions, such as depression and obsessive‐compulsive disorder. The aetiology of eating disorders in the elderly appears to be multifactorial, involving both vulnerability factors and precipitating factors. The outcome is often poor, although behavioural modification leads to a significant benefit in most cases. It is probable that these disorders are poorly recognized in the elderly, possibly because of a lake of suspicion and because the symptoms are often assumed to be secondary to an alternative physical or psychiatric cause.
Dissocial personality disorder in the elderly: A case history
Authors: Howard R. , Bandyopadhyay D. , Cook M. 
Published: December 2004

AbstractA case of dissocial personality disorder in a 71‐year‐old woman presented with dangerous and apparently suicidal behaviour. Such cases are rare and potentially difficult to distinguish from treatment‐resistant depression or organic cerebral conditions. In view of this, investment in prolonged inpatient assessment and an adequate trial of treatment for depression is justified. The prognosis for beneficial change is not good and eventual management may involve little more than providing an environment in which behaviours can be safely contained.
Short screening tests for dementia in the elderly population. I. A comparison between AMTS, MMSE, MSQ and SPMSQ
Authors: Hooijer C. , Dinkgreve M. , Jonker C. , Lindeboom J. , Kay D. W. K. 
Published: December 2004

AbstractThe coexistence of many screening tests for senile dementia raises the question of their potential differences. In an elderly community sample (n = 358), four different tests were applied in parallel. All tests were able to identify similar samples of subjects regarding sample size, age, education or depression. We failed to prove one test to be superior in predicting CAMDEX or AGECAT diagnoses of dementia. Yet, the individuals identified by different tests, and especially the cases of minimal dementia, were only partly identical and partly unique for each of the tests. There is a clear need for greater consensus about the use of screening tests for dementia.
Mental calculation in mild Alzheimer's disease: A pilot study
Authors: Parlato Vincenzo , Lopez Oscar L. , Panisset Michel , Iavarone Alessandro , Grafman Jordan , Boller FrançLois 
Published: December 2004

AbstractThe purpose of this study was to determine whether dyscalculia is present in the early stages of Alzheimer's disease (AD) and if it is associated with a characteristic neuropsychological pattern. We examined 28 probable AD patients with scores of 18 or greater on the Mini‐Mental State Examination (MMS) and with an educational level of 12 or more years. The ability to perform mental calculation was assessed by two tests: the Stamp Test (ST) and the Serial Seven Subtraction Test (SSST). The other cognitive domains were evaluated with an extensive neuropsychological battery. We found significant differences in performances on the calculation tests between patients and controls. The ST was correlated with attention and visuospatial skills, whereas the SSST was correlated with both receptive language and the MMS; both test were similarly correlated with productive language. This study suggests that impairment in mental calculation can be an early sign of AD. The ST seems to represent a more complex task dependent on attentional resources, whereas the SSST would be a purer measure of anarithmetia.
Which factors affect treatment response in late paraphrenia?
Authors: Howard Robert , Levy Raymond 
Published: December 2004

AbstractSixty‐four patients with late paraphrenia who had been prescribed neuroleptic treatment for at least three months in the previous year were clinically reviewed in order to asses their treatment response. At the time of assessment, 42.2% of the patients showed no response, 31.3% a partial response and 26.6% a full response to treatment. Compliance with medication, receiving depot rather than oral medication, and use of a community psychiatric nurse if the patient was an outpatient all had a positive effect on treatment response. Despite their better treatment response rate, patients prescribed depot medication received on average a lower daily dose in chlorpromazine equivalents than those prescribed oral medication. Improved compliance, greater clinical efficacy and a reduction in the dose of neuroleptic medication administered are all good reasons to commence treatment of late paraphrenia with a depot antipsychotic medication.
Morale in old age: A review of the evidence
Authors: Wenger G. Clare 
Published: December 2004

AbstractThis article presents a review of the literature on morale. It presents data on the correlates of morale and refers to related research on self‐image, self‐esteem and well‐being. The aim of the article is to give an overview of factors associated with morale identified in the literature. These are summarized in the table. The article points to the relevance of some of these findings for practice. Attention is drawn to the likely overlap and covariance of many of the correlates and it is suggested that multivariant approaches to the analysis of morale may lead to greater understanding of the primary factors. A statistical modelling approach to the problem is promised in a later article.
Falls among geropsychiatry inpatients are associated with prn medications for agitation
Authors: Aisen Paul S. , Deluca Teresa , Lawlor Brian A. 
Published: December 2004

AbstractA retrospective chart review study was conducted to determine risk factors associated with falls. All patients on a 23‐bed geropsychiatry service who fell during the course of one calendar year (17 patients, 30 falls) were compared to a control group of 30 non‐fallers from the same service and time period. The group of patients who fell during hospitalization was characterized by more frequent history of falls (18% vs 0%, p < 0.05) and ambulatory impairment (76% vs 47%, p < 0.05) and longer length of hospital stay (81 days vs 46 days, p < 0.02). There was no difference in number of medical diagnoses or standing medications between the fallers and non‐fallers, but the fallers were more frequently administered benzodiazepines (0.088 doses/day vs 0.034 doses/day, p < 0.03) and neuroleptics (0.039 doses/day vs 0.014 doses/day, p <0.06) on a PRN basis for agitation. We conclude that falls among geropsychiatry inpatients are associated with the administration of PRN benzodiazepines and neuroleptics to control agitation.
Community psychiatry of old age: A UK perspective
Authors: Dening Tom 
Published: December 2004

AbstractThis article is based on the examination of seven old age psychiatry in England in 1991, and it addresses the main issues in the organization of community‐orientated clinical services for elderly people with mental disorders. The current practice of old age psychiatry places much emphasis on assessment of patients at home wherever possible. Domiciliary assessments were performed by all the services, but there were marked differences in emphasis. The most controversial issue was whether all patients should initially be seen by a psychiatrist or whether assessments by non‐medical professionals were acceptable. Several areas of recent development in old age psychiatry are also discussed.
The nature of wandering in dementia: A Guttman scaling analysis of an empirical classification scheme
Authors: Albert Steven M. 
Published: December 2004

AbstractHope and Fairburn (1990) presented a typology of wandering behaviors based on the frequency of such behavior in a sample of community‐dwelling, demented elders. They then linked the nine types of wandering behaviors to a set of etiological components to show that the apparently disparate types of behavior lumped together as ‘wandering’ may actually have distinct neurologic or neuropsychiatric origins. In fact, the distribution of the types of wandering behavior in the sample points to a single latent variable, with a hierarchical structure that demonstrates the centrality of purposeless behavior in the class of wandering behaviors. This is shown in a Guttman scalogram.
Fragmentation of activity periods in Alzheimer's disease
Authors: Hopkins Robert W. , Rindlisbacher Peter 
Published: December 2004

AbstractActivity cycles were studied in 12 subjects clinically diagnosed with Alzheimer's disease. Subjects wore a movement sensor attached to a solid‐state ambulatory monitor for 96 consecutive hours each. Varying degrees of fragmentation of the normal diurnal activity pattern were observed. Subject variables such as age, estimated duration of illness, cognitive ratings, and months since first admission were compared for degree of association with the movement data. Simple regression analyses showed that an estimate of the duration of illness was superior to others in predicting the degree of fragmentation in activity rhythms. Pathology in the suprachiasmatic nucleus of the hypothalamus is discussed in the light of these findings.
Health, social functioning, and marital status: Stability and change among elderly recently widowed women
Authors: Bennett Kate Mary , Morgan Kevin 
Published: December 2004

AbstractFour‐year changes in mental and physical health, morale and social functioning were assessed in a random sample of elderly women widowed during the course of a longitudinal study, together with never‐married and still‐married controls. All groups showed an age‐related decline in mental and physical health, with the widows, the never‐married, and the still‐married displaying differing patterns of psychological change over time. However, while widows showed significantly greater changes in morale and personal disturbance, their levels of social functioning remained stable over the four‐year period. The results confirm earlier findings of lifestyle stability after the loss of a spouse and indicate that, in addition to bereavement per se, single status and ageing itself may contribute substantially to the measured longitudinal effects of widowhood.
Case report: Neuroleptic malignant syndrome in an elderly patient: Problems in management
Authors: Adityanjee  , Jayaswal S. K. , Chan S. P. , Subramaniam M. 
Published: December 2004

AbstractAn elderly patient with probable dementing illness was treated with haloperidol and trifluoperazine for control of agitation. The patient developed neuroleptic malignant syndrome characterized by cogwheel rigidity, deterioration in sensorium, hyperpyrexia, mutism, autonomic dysfunction, elevated leucocyte count and serum creatinine phosphokinase. After an initial diagnostic delay treatment with very low doses of bromocriptine resulted in hypotension followed by acute renal failure and death. Problems in the management of NMS in elderly patients with concurrent psychiatric illness and/or dementing illness are discussed.
Ageing and comorbidity among low‐income psychiatric outpatients
Authors: de Figueiredo John M. , Boerstler Heidi 
Published: December 2004

AbstractThe objective of this study was to determine if non‐psychiatric morbidity increases with age in a group of low‐income psychiatric outpatients. Data on demographics, presenting complaints, DSM‐III diagnoses and use of psychiatric services were collected on all individuals (N = 382) admitted to a psychiatric outpatient clinic serving low‐income population. Non‐psychiatric morbidity was identified on the basis of medical history, physical examination, and laboratory investigations. Bivariate analyses were done to determine the significance of the associations of comorbidity with other variables. A logistic regression was done using the presence or absence of comorbidity as the dependent variable. Age was the only variable which was significantly predictive of comorbidity. Additional resources should be allocated for the diagnosis and treatment of comorbidity among low‐income elderly.