bluuebunny/crossref_metadata_2025_split huggingface dataset:
A follow‐up study of elderly depressives and Alzheimer‐type dementia—relationship with DST status
Authors: Ferrier Nicol , Lister E. Susan , Riordan Denise M. , Scott Jan L. , Lett Debbie J. , Leake Alan , McKeith Ian G. 
Published: December 2004

AbstractSeventy‐three elderly patients (38 with Alzheimer‐type dementia (ATD) and 35 with major depressive disorder) were followed up 2–5 years after an index admission during which a dexamethasone suppression test (DST) had been performed. Clinical state, cognitive function, neurological status and repeat DST were assessed where possible. The death rate was high in both groups (greater in the ATD group) but was not influenced by original DST status. Original DST status did not predict on survival time, development of physical illness or admission rate in either group, but DST non‐suppression in the depressed group was associated with significant cognitive decline and abnormal neurological features. Possible mechanisms of the association are discussed.
Cognitive complaint and test performance in elderly patients suffering depression or dementia
Authors: Feehan Michael , Knight Robert G. , Partridge Fiona M. 
Published: December 2004

AbstractTen depressed elderly patients were compared with 20 age‐matched normal controls on measures of memory, perceptual organization, and speed of letter cancellation. Only on the letter cancellation task were there significant differences between groups. In contrast, 10 elderly patients with primary degenerative dementia (Alzheimer's type) performed more poorly than 10 age‐matched normal controls on all the cognitive tests employed. Depressed patients rated their level of dysfunction in performing everyday tasks as more severe than the controls; however, the demented patients rated their degree of deficit as significantly less severe than the normal controls. The relationship between patient's subjective ratings of their cognitive difficulties and their results on neuropsychological tests is discussed. The present data suggest that determining subjective complaint may be important when assessing geriatric patients.
Information reliability in dementia sufferers
Authors: Ballard C. G. , Chithiramohan R. N. , Handy S. , Bannister C. , Davis R. , Todd N. B. 
Published: December 2004

AbstractThe level of agreement between 58 patients suffering with dementia and their first‐degree relatives was assessed for various types of information using questions directly comparable between the patient and informant section of the Camdex schedule. The overall agreement was 76% but this fell considerably when specifically comparing answers for which the relatives' responses were positive. This indicates that the main form of error displayed was an under‐reporting of information by patients suffering with dementia. These findings pose important questions for clinical practice and research work. There is a need for further work to more precisely elicit the pattern of error and to investigate ways of improving information reliability.
Old age psychiatrists' views on the use of ECT
Authors: Benbow Susan Mary 
Published: December 2004

AbstractTwo hundred and five practising old age psychiatrists completed a questionnaire regarding their opinions and use of electroconvulsive therapy (ECT). Details of the psychiatrists and their jobs were recorded, their opinions were sought on ECT and they were asked their views regarding physical problems in association with treatment, as well as the treatment procedure they employed. The majority of respondents reported that they would consider using ECT for appropriate patients, but opinion diverged concerning who this might be. Agreement was greatest regarding when ECT would never be appropriate. Depressive psychosis was the condition where ECT was felt most often to be useful. Most respondents used bilateral ECT, and most commonly administered it twice weekly. There was broad agreement over when ECT might be the treatment of choice and whether certain psychotropic drugs should be discontinued during treatment. All respondents regarded physical examination as routinely necessary prior to treatment, but opinion diverged regarding other investigations. Similarly, views diverged regarding which physical conditions might constitute absolute or partial contraindications to ECT. ECT is regarded as useful by most old age psychiatrists, and age itself is not a contraindication to treatment.
Short‐term cognitive fluctuation in multi‐infarct dementia and dementia of the Alzheimer type
Authors: Taylor Robert , Gilleard Chris J. , McGuire Ralph J. 
Published: December 2004

AbstractShort‐term fluctuation in cognitive functioning was assessed in 13 subjects with presumed multi‐infarct dementia (MID) and 16 subjects with presumed dementia of the Alzheimer type (DAT) by administering a short battery of cognitive tests to subjects on three occasions over a period of approximately two weeks. The mean amount of fluctuation was small in both groups and was not generally greater in MID than in DAT subjects. Fluctuation therefore does not seem to be a universal characteristic of MID. No serious doubt is cast on the reliability of cognitive assessments made on a single occasion in either condition.
Epidemiology and diagnosis of alcoholism in the elderly (a review)
Authors: Caracci Giovanni , Miller Norman S. 
Published: December 2004

AbstractThe authors review the research on alcoholism in the elderly. There is evidence that prevalence studies underestimate its extent. Geriatric alcoholism often eludes detection as diagnostic criteria generally used for the adult may not apply to the elderly population. Issues pertaining to clinical features, classification and pattern of use are discussed.
Changes in survival in demented hospital inpatients 1957–1987
Authors: Wood Eric , Whitfield Elizabeth , Christie Alexander 
Published: December 2004

AbstractSeven cohorts of demented elderly patients who died in Crichton Royal Hospital between the years 1957 and 1987 were identified and their survival time during their terminal admission noted. There was an increase in mean survival time over this period which did not appear due to changes in age or in level of disability at the time of final admission, or in willingness to treat concurrent physical illness following admission. There was some evidence that treatments available for concurrent physical illness were more effective in postponing mortality in the later cohorts. It is suggested that, over the study period, medical advances have extended the life expectancy of the general population including those who develop dementia. Within the latter subgroup, however, there is no evidence that the time of onset or rate of decline to terminal disability of dementia has changed.
Survey of long‐stay psychogeriatric bed use: Implications for future provisions
Authors: Cope Denise 
Published: December 2004

AbstractThree hundred and twenty patients occupying long‐stay psychogeriatric beds were identified as compared to the Royal College of Psychiatrists' proposed number for this population of 470. Of these 7.1% were aged under 65 years, 11.3% had a diagnosis of functional illness and 75% were over 75 years. Existing guidelines for bed provision for the elderly mentally ill do not account for these numbers of under 65, functionally ill or the rapidly expanding number of over 75 year olds. Fixed guidelines for bed provision are inappropriate for this population; at present they are too high, but with the uncertainty surrounding the funding of community care they may well prove to be too low here as in other areas.
Major depressive disorder in the elderly: The relationship between age of onset and cognitive impairment
Authors: Steingart A. , Herrmann N. 
Published: December 2004

AbstractIn order to determine if later age of onset of depression in the elderly is associated with increased cognitive impairment, the scores on the Mini‐Mental State Examinations of 41 elderly depressed patients were correlated with the ages of onset of depression. All subjects, average age 74.7, were referred to a psychiatric day hospital for treatment of a major depressive disorder, and all scored at least 14 on the 17‐item Hamilton Depression Rating Scale. The ages of first mental health contact and symptom onset were significantly negatively correlated with Mini‐Mental State scores (p =0.021 and 0.035 respectively) after the confounding effect of age was adjusted for using partial correlations. The relation between late‐onset depression and cognitive impairment lends support to the hypothesis that late‐onset depressive disorders in the elderly may be associated with occult brain disease.
Wandering in dementia sufferers
Authors: Ballard C. G. , Mohan R. N. C. , Bannister C. , Handy S. , Patel A. 
Published: December 2004

AbstractNinety‐two patients with dementia were thoroughly assessed by domiciliary interview and a period of day hospital attendance which included the completion of Camdex and Camcog schedules. Domiciliary visit letters described getting lost outside the home as a problem in 20.6% of patients, and inside the home in 3.3% of patients. The corresponding figures obtained from interviews were 36.9% and 28.3%. According to interview data, patients with senile dementia of Alzheimer's type were more likely to get lost outside the home than those with vascular dementia and there was no correlation between the severity of cognitive impairment and the prevalence of getting lost outside the home.
Interobserver reliability of the italian version of the geriatric mental state examination
Authors: Turrina Cesare , Perdona Giampietro , Bianchi Lucian , Cordioli Luciano , Burti Lorenzo , Micciolo Rocco , Copeland John R. M. 
Published: December 2004

AbstractThe Italian version of the Geriatric Mental State Examination (GMS) was tested for interrater agreement (interobserver). Thirty geriatric patients form psychiatry, neurology and general medical facilities were interviewed by four raters. The mean values of kappa and phi for the analysable items were 0.80 and 0.81. ‘Organic’ and ‘functional’ items produced very similar coeffcient values.
Non‐neuroleptic medications in the management of agitation in Alzheimer's disease and other dementia: A selective review
Authors: Schneider L. S. , Sobin P. B. 
Published: December 2004

AbstractBoth neuroleptic and non‐neuroleptic medications are widely used to treat symptomatic behaviors in dementia patients. There is a substantial body of literature suggestig that neuroleptics are modestly effective in treating these symptoms, but the magnitude of their effect is limited. Non‐neuroleptic medications such as anticonvulsants and antidepressants have been advocated as useful in treating certain symptoms but have not been as well studied. This article critically reviews the published evidence for the effectiveness of selected non‐neuroleptic medications in treating behavioral symptoms in elderly dementia patiens, especially those with possible Alzheimer' disease. The medications reviewed include lithium, β‐adrenergic blockers, trazodone, carbamazepine, buspirone, I‐deprenyl, and serotonin uptake blockers, reflecting the point of view that pharmacological approaches to the problem of agitation in dementia have included a variety of psychotropic medications. Most of these medications were not tried specifically with Alzheimer' disease patients, however, but in patients with various organic mental syndromes. The literature consists almost entirely of clnical series and case reports, making interpretations of the efficacy of individual medications difficult. With the singular exception of the serotonin uptake blocker citalopram, the few placebo‐controlled studies are of small sample sizes, showing at best very modest efficacy for the study medication. Despite their widespread use, there is very little published empirical evidence for the effectiveness of these novel treatments for treating behavioral symptoms in elderly dementia patients.
Quantitative CT scan analysis in senile dementia of the Alzheimer type: II. Radioattentuation of grey and white matter
Authors: Förstl Hans , Burns Aliatair , Jacoby Robin , Eagger Sarah , Levy Raymond 
Published: December 2004

AbstractThe radiodensity of the total intracranial area and of the dorsomedial thalamic nuclei were significantly lower in 60 patients with moderate to severe dementia of the Alzheimer type (DAT) compared to 30 healthy age and sex‐matched controls (p<0.02). The radiodensity of the caudate nuclei was similar in the DAT and the coantrol these effects did not exhibit significant correlations with age, duration of illness or global cognitive impairment. The denstitometric parameters discriminated 78.4% of patients and controls; together with the olanimetric measurements 84.4% of the individuals were classified correctly. A potential contribution of white matter shrinkage to ‘cortical atrophy’ and the possible role of thalamic degeneration in DAT are briefly discussed.
The domus philosophy: A comparative evaluation of a new approach to residential care for the demented elderly
Authors: Lindesay James , Briggs Kate , Lawes Matthew , MacDonald Alastair , Herzberg Joe 
Published: December 2004

AbstractThis study reports a cross‐sectional comparison between three continuing care facilities for severely disturbed elderly demented people: two mental hospital psychogeriatric wards and a unit run according to the domus philosophy of care. The domus was characterized by greater expectations for residents' functioning, policy choice, resident control and availability of social and recreational activities. The level of staffing was higher on the domus than on the two wards. The residents on the three settings were broadly comparable with regard to age, diagnosis, length of stay, objectively assessed cognitive impairment and depression, but the domus residents were rated by the staff as less disabled in self‐care tasks, orientation and communication. Direct non‐participant observation using the Short Observation Method demonstrated significantly higher levels of activities and staff‐resident interaction on the domus compared to the hospital wards. There were no differences between the settings with regard to staff absenteeism, job turnover or psychological impairment, but the domus staff expressed higher levels of job satisfaction. These findings are discussed in the context of the limitations of study design and method.
Who should care for the frail elderly? A survey of medical and nursing staff
Authors: Victor Christina R. 
Published: December 2004

AbstractCommunity care has been the main policy for the care of frail elderly people in Britain in the postwar period. Currently most care is provided by the informal sector, with state domiciliary services playing a residual role. In long‐term hospital beds or residential/nursing homes, institutional care is received by only a minority of elderly and has a very poor public image. One hundred and thirty‐nine medical and nursing hospital staff in an inner London health district were surveyed about (a) their knowledge of elderly people and (b) their views on the care of the frail elderly. Respondents overestimated the proportion of elderly in the general population and the proportion receiving community care services. Community care as opposed to institution care was the respondents' favoured general policy option. However, when presented with different types of frail elderly varying responses were elicted. For personal care tasks the family was seen as the most appropriate provider; state domiciliary services were seen as appropriate for house care tasks and incontinence. For severe dementia institutional provision and domiciliary services and not the family were the favoured care option. This illustrates that the frail elderly are not a homogeneous group and policies for their care must recognise the diversity of needs which this group presents.
Single photon emission tomography in Alzheimer's disease. A longitudinal study of changes in relative regional cerebral blood flow
Authors: Philpot Michael P. , Costa Durval C. , Burns Alistair , Levy Raymond , Ell Peter J. 
Published: December 2004

AbstractRelative regional cerebral blood (rCBF) was measured in 10 patients fulfilling NINCDS‐ADRDA criteria for Alzheimer's disease using Tc‐99m‐HMPAO single photon emission tomography (SPET). In comparison with 11 age‐matched control subjects, relative rCBF was reduced in lateral and medial temporal areas. SPET was repeated after 12‐18 months. Relative rCBF fell significantly in the frontal and anterior and posterior parietal areas. Significant changes in left/right asymmetry were found in the frontal and posterior parietal areas suggestinga greater reduction in left hemisphere rCBF. There were few associations between relative rCBF and neuropsychological test performance.
Semiquantitative I‐123 IMP spect studies in late onset depression before and after treatment
Authors: Kumar Anand , Mozley David , Dunham Chris , Velchik Michel , Reilley John , Gottlieb Gary , Alavi Abass 
Published: December 2004

AbstractNine subjects with late onset unipolar depression were studied, before and after treatment, using I‐123 iodoamphetamine SPECT. In all nine subjects clinical improvement was associated with a significant increase (p<0.01) in cerebral/cerebellar activity ratios that correlated well with the decline in Hamilton depression scores.
Validity of a brazilian version of the mental status questionnaire as a screening test for dementia among elderly urban subjects. A pilot study
Authors: Blay Sergio Luis , Mari Jair De Jesus , Ramos Luiz Roberto , Ferraz Marcos Pacheco T. 
Published: December 2004

AbstractValidity of the Mental Status Questionnaire (MSQ) was assessed by comparing the screening scores against a standardized psychiatric evaluation, the Clinical Interview Schedule. In a pilot study patients with dementia were divided into two subgroups: Mild and moderate/severe cases. Including patients with mild dementia in the dementia group, the best balance between sensitivity and specificity fell at cutoff point 1/2. The validity coefficients were as follows: Sensitivity 80.0%, specificity 60.5% positive predictive value 10.5%, negative predictive value 98.1%, and overall misclassification rate 38.5%Including mild dementia in the non‐dementia group, we observed that with six errors in the questionnaire the validity coefficients for moderate/severe dementia were: sensitivity 100.0%, specificity 94.4%, positive predictive value 16.7%, negative predictive value 100.0%, overall misclassification rate 5.5%. A discriminant analysis was run in order to select the most discriminant MSQ items for detecting dementia. Factors associated with misclassification in the questionnaire were investigated.
Depression in the elderly in the community: Effect of physical illness and selected social factors
Authors: Evans Mavis E. , Copeland John R. M. , Dewey Michael E. 
Published: December 2004

AbstractDepressive illness in the elderly may be the result of a physical illness, the cause of secondary physical problems, coincidental tophysical illness or the result of an aetiological factor common to both conditions. Analysis of a cross‐sectional community sample of 396 elderly people showed depression to be significantly linked to presence of headaches, dyspnoea, and malignant disease known to the patient. It was not linked with heart disease nor arthritis per se, although those on anti‐arthritic or analgesic medication were significantly more depressed. The subjective description of physical health given by the patient also correlated strongly with depression.Depressive illness is sometimes unrecognized and frequently untreated with a consequent reduction in quality of life for many patients. Clinicians must be aware of the possibility that depression may coexist with physical illness, and that both conditions may need appropriate treatment.Further analysis of the above sample, controlling for physical illness and the additive effect of the variables concerned, showed depression to be positively correlated with adverse social factors such as not going out because of physical disability, feeling lonely, having a shopper and having hearing difficulties. The home help service was identified as a probable protective factor, implying the importance of this service in supporting the emotional as well as the physical needs of its clients.
The families of the institutionalized dementing elderly: A preliminary study of stress in a French caregiver population
Authors: Ritchie Karen , Ledésert Bernard 
Published: December 2004

AbstractThe present study describes the development of a measure of stress in the family caregivers of institutionalized dementing elders using a brief two‐dimensional scale. Univariate and multivariate analysis of the responses of 257 French adult caregivers to the scale suggest that a year after the admission to care unhappiness is expressed by a third of the population, principally due to exclusion from the caregiving role, financial burden, problems with family and poor contact with staff. Responses appear to be independent of the degree of dementia, the presence of associated pathology in the institionalized elder and recency of admission. Significantly greater satisfaction with care lower levels of stress were reported by caregivers with a relative in non‐medical communal care as opposed to a long‐stay hospital.
An investigation of the sundowning syndrome
Authors: Rindlisbacher Peter , Hopkins Robert W. 
Published: December 2004

AbstractGeriatric clinicians have observed that some demented individuals show increased agitation, restlessness and confusion in late afternoon, evening or night. This has popularly been named ‘sundowning’, or the ‘sundowning syndrome’. References to ‘sundowning’ in clinical writings disagree on virtually every aspect of the syndrome, and little research has been conducted to investigate this phenomenon.In this study, agitation was measured in terms of motor activity, using an electronic monitor with a movement sensor. A total of 12 demented Alzheimer's patients were continuously monitored for four days each. Analyses indicated that some subjects showed increased afternoon activity, but these individuals did not correspond to nursing‐assigned groups of ‘sundowners’ and ‘non‐sundowners’. Movement correlates of ‘sundowning’ were seen in Alzheimer's patients presumably in the mid‐stages of the dementia, and less so in patients with more years of illness.
Mental illness among new residents to residential care
Authors: Clark Stella Anne 
Published: December 2004

AbstractThe prevalence of organic impairment, depressive illness and anxiety was assessed in 32 subjects (group A) within two weeks of admission to one of four local authority homes for the elderly in Fife, Scotland. This group was compared with an age and sex matched control group (group B) who continued to live at home. Both groups were reinterviewed six months later.Levels of organic impairment, depression and anxiety were significantly higher in group A at the time of admission. At follow‐up, levels of organic impairment and depression remained unchanged in both groups. The level of anxiety was significantly lower in group A but remained unchanged in group B at follow‐up.Forty per cent (13 subjects) of group A were diagnosed at first interview as suffering from major depressive episode, minor depressive disorder, generalized anxiety disorder and/or phobic disorder but no‐one was receiving treatment.This study reinforces the case for specialist assessment prior to admission to residential care as advocated by the British Geriatric Society. Improved liaison between social and psychiatric services is essential if psychiatric morbidity in the elderly is to be identified and treated, and residential places are to be used appropriately.