bluuebunny/crossref_metadata_2025_split huggingface dataset:
The social environment of the agitated nursing home resident
Authors: Cohen‐Mansfield Jiska , Werner Perla , Marx Marcia S. 
Published: December 2004

AbstractThis study describes the characteristics of the social environment of 24 highly agitated and cognitively impaired nursing home residents, and the relationship between manifestations of agitation and attributes of the social environment. Results showed that the composition of the social environment of the agitated nursing home resident does not vary much with respect to time of day or day of the week. Additionally, most agitated behaviors were not generally affected by attributes of the social environment. The interaction of agitated behaviors with persons in the social environment is also examined. When agitated behaviors were directed towards someone, they were most likely to be directed towards staff members. Agitated behaviors were rarely triggered by any observable event, and few reactions to agitation were observed.
Brief report: Abnormal eating behavior in dementia—a descriptive study
Authors: Trinkle David B. , Burns Alistair , Levy Raymond 
Published: December 2004

AbstractRecent research has focused on the behavioural disturbances in dementia patients. The authors review the literature on abnormal eating behaviour in dementia patients and then retrospectively examine a large cohort of dementia patients for such patterns. Thirteen per cent of these patients were found to have significant abnormalities in eating behaviour. These patients are described and possible aetiologies are discussed. A more thorough description of the non‐cognitive symptomatology of dementia is considered important for future research on dementia syndromes.
A survey of lithium use in the elderly
Authors: Bramble David 
Published: December 2004

AbstractA survey of 37 psychiatrists practising within a health authority area revealed that they employed lithium therapy in elderly patients in a similar manner to how they used it in younger patients. Their responses to a questionnaire were compared to pooled laboratory data concerning lithium serum estimations. There was general agreement between clinicians concerning the important aspects of treatment, yet there were some variations in terms of pretreatment screening practice and maintenance monitoring practice which have resource implications. Overall, lithium was regarded as being as useful in the elderly as in younger patients and also appeared, from analysis of objective laboratory data, to be used in similar ways in this group.
A case of senile self‐neglect in a married couple: ‘Diogenes à deux’?
Authors: Cole Andrew J. , Gillett Timothy P. , Fairbairn Andrew 
Published: December 2004

AbstractA case is presented of senile self‐neglect in a cohabiting pair. Many features of what has been called Diogenes syndrome are illustrated. Aetiological factors are discussed and parallels with models for folie À deux are drawn.
The psychiatry of elderly people with mental handicaps
Authors: Cooper Sally‐Ann 
Published: December 2004

AbstractLittle is known about the prevalence of psychiatric illness in elderly people with mental handicaps. Behaviour disorders occur less often in the elderly compared to younger groups, but which other illnesses they are vulnerable to or protected from is unknown. Associated characteristics are not clear, not is the interrelationship with social factors. Issues of treatment have not been addressed. Postmortem studies in Down's syndrome suggest almost 100% of individuals over 40 to have neuropathological changes of Alzheimer's disease, but this is probably an overestimation of the true prevalence. Attempts to link neuropathological findings with clinical findings have been disappointing; clinical dementia is elusive. When a decline in skills has been elicited, studies have often overlooked the differential diagnosis, making a presumptive diagnosis of Alzheimer's disease. To date there has been no comprehensive prospective study with neuropathological correlates in the field of Down's syndrome and dementia. People with mental handicaps are living longer, and hence the elderly are emerging as a new group in our society. The impact that this will have on services cannot be predicted and planning of provisions cannot be made until there is more knowledge about this group of individuals.
Psychic correlates of sleep symptoms in the elderly
Authors: Frisoni Giovanni B. , de Leo Diego , Rozzini Renzo , Bernardini Maria , Buono Marirosa Dello , Trabucchi Marco 
Published: December 2004

AbstractNight sleep symptoms and their relationship to a number of psychic, somatic and social variables were investigated in 453 elderly subjects living in the community. Multivariate statistics indicated that: (a) higher levels of somatization and anxiety were independently associated with worse quality of sleep; (b) depression was not independently associated with poor sleep quality, and association in univariate analysis was explained by higher levels of somatization; (c) sexual interest, which may be an indicator of active sexual life, was associated with better sleep quality both in elderly men and women; (d) waking up frequently in the night showed a correlation pattern with psychic, social and somatic variables different from the other sleep symptoms, suggesting a different cause.
Measurement of depression in dementia: Self vs clinician rating
Authors: Ott Brian R. , Fogel Barry S. 
Published: December 2004

AbstractThe presence of depression was evaluated in a cross‐section of 50 outpatients with dementia using the self‐rated Geriatric Depression Scale and the clinician‐rated Cornell Depression Scale. Impaired insight, as manifested by unawareness of dementia, correlated with dementia severity and discriminated a group of patients in whom the self‐rated scale failed to show evidence of depression. Discrepancy between the two types of scales occurred among mildly as well as moderately demented patients when insight was impaired. Recognition of this discrepancy suggests that reliance on self‐ratings may underestimate the presence and degree of depression among patients with dementia.
Case report: Efficacy of verapamil in an elderly patient with mania unresponsive to neuroleptics
Authors: Gash A. J. , Cole A. J. , Bray G. P. 
Published: December 2004

AbstractThis is a case report of an elderly hypertensive patient with mania relatively unresponsive to neuroleptics, whose illness was effectively controlled with verapamil in both the acute and the maintenance phase of treatment.
Evolution of research in geriatric psychiatry
Authors: Kalayam Balu , Shamoian Charles A. 
Published: December 2004

AbstractDuring the past 30 years the knowledge base of geriatric psychiatry has grown exponentially to replace the folklore and myths which for many years pervaded the as yet undefined field of geriatric psychiatry. The advances in geriatric psychiatry, as with many areas of medicine, have been fostered by the appearance of sophisticated technologies including analytic chemistry techniques, functional and structural brain‐imaging studies and molecular biology. However, many of these advances could not have been achieved without the supported initiatives in education and research in geriatric psychiatry by major agencies such as the National Institute of Mental Health Center for Studies of Mental Health of the Aging and the National Institute for Aging. For example, the number of geriatric specialty training programs in the United States increased to more than 30 between 1978 and 1989 as compared to the existence of only one prior to 1978 in the setting of a medical school (Cohen, 1989). These clinical and research training programs continue to the present day and are not only the source of the future researchers in geriatric psychiatry but also the ‘centres’ of research activity in areas such as the mood disorders, dementias, late onset schizophrenia, anxiety, and other psychiatric disorders of the elderly which are reviewed in this issue of the Journal.
Funding research structures
Authors: Martinez Rick A. , Lebowitz Barry D. , Cohen Gene D. 
Published: December 2004

AbstractResearch priorities established by the field of geriatric psychiatry are the principal source of ideas for investigations supported by the National Institute of Mental Health, the National Institute of Aging and a host of private organizations and foundations. Individuals, at various stages in their careers, can compete for federal stipends to pursue these research inquiries. Knowledge of the assortment of awards available is part of an overall strategy candidates need to develop in planning and maintaining productive research careers.
Epidemiology of alzheimer's disease: Research trends in the united states
Authors: de Figueiredo John M. 
Published: December 2004

AbstractIn the absence of a peripheral biochemical marker of Alzheimer's disease, case identification in community epidemiologic studies has to rely on a probabilistic diagnosis based on the exclusion of other causes of dementia. This article is a review of the advances made in the successive steps of this diagnostic process. Representative epidemiologic studies on diagnosis, prevalence, incidence, lifetime cumulative risk, mortality, risk factors, prognosis, and the overlap of dementia and depression are reviewed and discussed. Differences in case ascertainment and the methods used have, at times, led to conflicting findings. The recognition of these differences and the experience gained by the studies done so far are paving the way for new initiatives aimed at a better understanding and resolution of the issues left unsettled.
Subtypes in alzheimer's disease and the impact of excess disability: Recent findings
Authors: Fenn Howard , Luby Victoria , Yesavage Jerome A. 
Published: December 2004

AbstractThis article reviews selected recent findings which contribute to the delineation of the early onset, extrapyramidal symptom, and Lewy body subtypes. These examples underscore certain potential advances and pitfalls in research which attempts to define subtypes. A subtype of Alzheimer's disease is defined by the presence of a specific etiology, a set of clinical signs, a prognosis, and a response to treatment. Cognitive decline can also occur on the basis of factors not intrinsic to a particular subtype. The term ‘excess disability’ refers to a patient's functioning which declines more rapidly than is expected on the basis of cerebral pathology alone. This article discusses some relevant studies which show how the concept of ‘excess disability’ contributes to understanding the total disability of the Alzheimer's patient.
Psychosocial treatment of the geropsychiatric patient
Authors: Weiss Leonard J. , Lazarus Lawrence W. 
Published: December 2004

AbstractAlthough clinicians believe strongly in the efficacy of various psychotherapeutic approaches to the geropsychiatric patient, to date there have been relatively few studies to validate these claims. We will selectively review some of the more clinically relevant studies concerning individual psychodynamic, cognitive, and behavioral psychotherapy, focusing on treatment of the depressed geriatric patient. Also reviewed are studies about the cost‐effectiveness of psychiatric intervention, as well as innovative hospital‐based treatment modalities. Although progress has been made, Rechtschaffen's succinct summary of the psychotherapy literature in 1959 is still pertinent today; ‘As is true for psychotherapy as a whole, systematic, controlled studies of the effectiveness of various treatments of older people are still lacking. Ultimately, there must be empirical grounds for predicting which type of treatment will work best for which type of patient’ (Rechtschaffen, 1959).
Late life depression and structural brain changes: A review of recent magnetic resonance imaging research
Authors: Baldwin R. C. 
Published: December 2004

AbstractRecent findings using magnetic resonance imaging to investigate late life depression have reported an unexpectedly high prevalence of white matter and other structural brain changes, suggesting a possible organic aetiology to the disorder in a proportion of cases. These findings are examined critically and it is concluded that their significance is not yet clear, although they may reflect underlying cerebrovascular change. A lack of postmortem data constitutes a major deficiency in this area of enquiry. An approach combining structural and dynamic imaging with postmortem examination would be the best strategy for future research.
Intervening to reduce distress in caregivers of impaired elderly people: A preliminary evaluation
Authors: Harper David J. , Manasse Paul R. , James Owen , Newton J. Tim 
Published: December 2004

AbstractData from a sample of 82 impaired elderly people and their carers were gathered before (T1) they started to receive support from a home‐based care aide service. Several variables were significantly correlated with, but only two were predictive of reported carer distress at T1. Data gathered from a subsample of 45 carers after receiving support for 3 months (T2) showed that reported distress decreased significantly between T1 and T2. The only variable which significantly correlated with, and was predictive of carer distress at T2 was distress at T1. A ladder plot showed great variability in changes in distress with 11 subjects actually reporting increased distress at T2. There was no relationship between initial distress scores and change in distress over time. The implications of these findings are discussed.
Factors associated with mortality in national health service nursing homes for elderly people and longstay geriatric wards in hospital
Authors: Bowling Ann , Formby Juliet , Grant Kenneth 
Published: December 2004

AbstractThis article presents the analyses of mortality rates of elderly people in a randomized controlled trial of nursing home and long‐stay ward care in hospital. No statistically significant differences between settings were found in relation to mortality rates. Age, accident rate and existence of cognitive impairment were associated with mortality with bivariate analyses, although they were found to explain very little of the variation between survival and mortality when logistic regression analysis was employed. In both settings, those who had some cognitive impairment had just over twice the relative risk of dying than others, although this difference was not statistically significant.
Housebound elderly people: Definition, prevalence and characteristics
Authors: Lindesay James , Thompson Catherine 
Published: December 2004

AbstractThis study examines various physical, psychiatric, social and environmental factors associated with being housebound in an urban elderly community sample. Using a narrow definition of houseboundness, the overall rate in this sample was 3.5%; in respondents aged 85 years and over the rate was 20.0%. In a logistic regression analysis, physical health status, age, access to a car, floor of entry to household and household tenure emerged as significant independent predictors of houseboundness. Psychiatric disorder was not independently associated with houseboundness in this analysis. Housebound respondents reported higher rates of both formal and informal care; in those aged 65–74 years this extra care was provided by domiciliary health and social services, but in those aged 85 years and over only care by home helps and by family and friends was increased.
First symptoms of dementia: A study of relatives' reports
Authors: La Rue Asenath , Watson Jennifer , Plotkin Daniel A. 
Published: December 2004

AbstractFifty relatives who accompanied patients to a dementia clinic for diagnostic evaluation completed questionnaires inquiring about initial symptoms of illness, changes in symptoms over time, current functional and psychiatric problems of the patient, and caregiver stress. Forgetfulness was the most commonly reported initial symptom, followed by confusion, depression, agitation, inattention, getting lost, language problems, and motor problems. Usually, multiple initial symptoms were endorsed (mean = 3.28 ± 1.83). Spouses reported fewer initial symptoms overall and less frequent depression than younger relatives. In addition, there was a significant relationship between informants' reports of first symptoms and the reported levels of caregiver stress and current psychiatric problems in patients. Patients with clinical diagnoses of Alzheimer‐type or multi‐infarct dementia had a different profile of initial symptoms from those with mood disturbance, but there was no difference in reported symptoms between the dementia groups.
The prevalence of psychotic, depressive and anxiety syndromes in demented and non‐demented 85‐year‐olds
Authors: Skoog Ingmar 
Published: December 2004

AbstractOne‐month prevalence of mental syndromes in demented and non‐demented subjects was studied in a representative sample of 85‐year‐olds living in Gothenburg, Sweden (N = 494). All subjects were examined by a psychiatrist. Schizophreniform syndrome was significantly more common in subjects with Alzheimer's disease than in nondemented subjects (13% vs 1%, p < 0.001), and more common in severe dementia (p > 0.01). Depressive syndromes were significantly more common in subjects with mild dementia than in non‐demented subjects (34% vs 20%, p > 0.05). Phobic syndrome was less common in demented than in non‐demented subjects. It is hypothesized that the occurrence of mental syndromes in demented subjects may be related to structural and neurochemical brain changes.
Does psychiatric morbidity predict mortality in continuing care geriatric inpatients?
Authors: Shah Ajit , Phongsathorn Virach , George Collette , Bielawska Celia , Katona Cornelius 
Published: December 2004

AbstractAll patients in continuing care geriatric beds in a London Health District were screened for psychiatric morbidity and physical dependency in 1990. This sample was followed up 1 year after screening. Forty‐four per cent (32/72) were dead at follow‐up. Patients in hospital‐based continuing care beds had higher mortality than those in health authority beds in a private nursing home. Dementia, physical dependency and depression measured by Depressive Signs Scale (DSS) were associated with mortality. Using multivariate analysis, to partial out independent effects, depressive signs score measured by the DSS was the only significant predictor of mortality.
Age‐associated memory impairment: Diagnostic and treatment issues
Authors: Barker Andrew , Jones Roy 
Published: December 2004

AbstractThere has been an enormous increase in research to identify potential pharmacological treatments for cognitive impairment in elderly people. Currently, well over 150 such compounds are under development by the pharmaceutical industry. However, among those who are potential targets for such treatment are many who suffer from relatively mild disorder, where the distinction from both dementia and ‘normality’ is not clear. These people include those described as suffering from benign senescent forgetfulness and age‐associated memory impairment. This article discusses principles of diagnosis and treatment in this area with particular reference to age‐associated memory impairment. For ethical, practical and economic reasons it is essential that these issues are examined thoroughly before any apparent breakthrough in therapy.
Clinical experience with the nosger (nurses' observation scale for geriatric patients): Tentative normative data and sensitivity to change
Authors: Tremmel Lothar , Spiegel René 
Published: December 2004

AbstractThe NOSGER is an assessment instrument used in psychogeriatrics, consisting of 30 observable items of behaviour and measuring impairments in six areas: memory, IADL (instrumental activities of daily living), ADL (activities of daily living), mood, social behaviour and disturbing behaviour. Data collected in the course of validation studies were reanalysed to calculate tentative normative scores and to assess the scale's sensitivity to change. Cutoff scores for elderly normal subjects living in the community are estimated around 10 for ADL and around 15 for memory and IADL disturbances. Cutoff values for the three non‐cognitive NOSGER dimensions are not yet available. Sensitivity to change (over 3 months) was shown to be relatively highest for memory, IADL and disturbing behaviour and lowest for ADL in a group of patients with mild to moderate dementia. Correlations between NOSGER change scores and physicians‐ overall assessments of treatment efficacy in a drug study were highest for social behaviour, IADL and mood, suggesting that non‐cognitive factors were at least as important to determine doctors‐ assessments of change as changes in cognitive areas of behaviour. Further studies are on their way to supplement the present data set.
Screening for problem drinking in the elderly: A study in the elderly mentally ill
Authors: Mears Helen J. , Spice Claire 
Published: December 2004

AbstractAbuse of alcohol in the elderly may be commoner than previously thought, but accurate detection is hampered by, among other things, lack of information about the most suitable screening or detection methods in this group. One hundred and ten consecutive admissions to an acute unit for the elderly mentally ill were studied to identify problem drinkers and to examine characteristics of these patients. The prevalence of problem drinking was found to be 19%, one third of whom had been undetected during routine medical assessment. A highly significant difference in consumption of alcohol was found between problem drinkers and the remainder of the group (p<0.001), with consumption of 14 or more units of alcohol per week in males and females being associated with high risk of adverse consequences. Thus, consumption of 14 or more units of alcohol per week may be applied as a useful screening test for problem drinking in the elderly, with sensitivity of 0.92 and specificity of 0.98. The pattern of drinking showed a similar distinction with consumption of alcohol on 3 or more days per week being associated with high risk of adverse consequences (p<0.001).
The single eeg in alzheimer's disease: What value for prognosis?
Authors: Bach L. , McCulloch J. , Hunter R. 
Published: December 2004

AbstractThe article reports an investigation into whether abnormal EEG patterns are predictive of faster rate of decline in patients with Alzheimer's disease. Data for 24 patients with probable Alzheimer's disease (NINCDS‐ADRDA criteria) were analysed. Patients were divided into two groups, those with normal EEG pattern (N = 9) and those with abnormal EEG pattern (N = 15). There was no difference between the initial MMSE and CAMCOG scores for either group. There was also no difference in terms of rate of decline, as measured by MMSE and CAMCOG scores, between patients with normal and abnormal EEG records. We therefore conclude that the single EEG is of limited value in predicting rate of cognitive decline in Alzheimer patients.
Aggressive behaviour in elderly people with dementia: A review
Authors: Patel Vikram , Hope Tony 
Published: December 2004

AbstractThe progressive degeneration of the brain seen in dementia is often accompanied by behavioural disturbances. Aggressive behaviour is one of the most serious of these disturbances and is a common cause for psychiatric referral, admission to hospital and drug treatment. In this article, we discuss the conceptual issues associated with defining aggressive behaviour in cognitively impaired patients. We then review the aetiology, epidemiology, methods of assessment, and management of aggressive behaviour in elderly people with dementia.