bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aging of the nigrostriatal system in the squirrel monkey
Authors: McCormack Alison L. , Di Monte Donato A. , Delfani Kioumars , Irwin Ian , DeLanney Louis E. , Langston William J. , Janson Ann Marie 
Published: March 2004

AbstractIncreasing incidence of Parkinson's disease with advancing age suggests that age‐related processes predispose the nigrostriatal dopaminergic system to neurodegeneration. Several hypotheses concerning the effects of aging on nigrostriatal neurons were assessed in this study using a non‐human primate model. First, we examined the possibility that the total number of dopaminergic neurons decline in the substantia nigra as a function of age. Stereological counting based on both tyrosine hydroxylase immunoreactivity (TH‐ir) and neuromelanin (NM) content revealed no difference in cell number between young, middle‐aged and old squirrel monkeys. We then determined whether advancing age changed the relative proportion of neurons characterized by 1) TH‐ir in the absence of NM, 2) the presence of both TH‐ir and NM, or 3) NM without TH‐ir. Indeed, a progressive age‐related depletion of TH only cells was paralleled by an increase in NM only neurons. The possibility that these changes could underlie a functional impairment of the nigrostriatal system was supported by striatal dopamine measurements showing a decrease in older monkeys. Finally, we tested the hypotheses that aging may enhance cell vulnerability to injury and that different dopaminergic subpopulations display varying degrees of susceptibility. When monkeys were exposed to the neurotoxicant 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine, cell loss was markedly more pronounced in older animals, and the ranking of vulnerability was TH only < TH/NM < NM only cells. The data indicate that, even in the absence of an overall neuronal loss, changes in the characteristics of dopaminergic cells reflect functional deficits and increased vulnerability to injury with age. NM content appears to be an important marker of these age‐related effects. J. Comp. Neurol. 471:387–395, 2004. © 2004 Wiley‐Liss, Inc.
Validity and reliability of the newly translated Hellenic Neuropsychiatric Inventory (H‐NPI) applied to Greek outpatients with Alzheimer's disease: a study of disturbing behaviors among referrals to a memory clinic
Authors: Politis Antonis M. , Mayer Lawrence S. , Passa Maria , Maillis Antonis , Lyketsos Constantine G. 
Published: March 2004

AbstractContextNo rating scales of the neuropsychiatric symptoms of patients with dementia and Alzheimer's disease (AD) have previously been developed or translated.ObjectivesTo develop a Hellenic translation of the Neuropsychiatric Inventory (NPI), to evaluate it's reliability and validity, and to compare NPI results in Greek patients referred to a neuropsychiatry clinic for either of two reasons: disturbing behaviors evoking embarrassment and disturbing behaviors evoking fear in the caregiver.MethodsThe Hellenic translations of the NPI, Brief Psychiatric Rating Scale (BPRS), and Emotional Distress Scale (EDS) were compared in evaluating 29 consecutive referrals of patients with AD.ResultsThe Hellenic NPI (H‐NPI) demonstrated a high degree of internal consistency reliability, and of concurrent validity when compared to the BPRS or the EDS. Patients referred for behaviors evoking embarrassment presented with higher scores on NPI ratings of apathy. However, patients referred for behaviors evoking fear presented with higher scores on NPI ratings of aggression and irritability.ConclusionsThese results indicate that the H‐NPI is a reliable instrument, able to detect differences in clinically referred groups of AD patients. Copyright © 2004 John Wiley & Sons, Ltd.
Differential associations of Head and Body Symptoms with depression and physical comorbidity in patients with cognitive impairment
Authors: Riello Roberta , Geroldi Cristina , Zanetti Orazio , Vergani Carlo , Frisoni Giovanni B. 
Published: March 2004

AbstractObjectiveTo test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment.MethodsSubjects were taken from those enrolled in ‘The Mild Project’ a prospective study on the natural history of mild dementia (Mini Mental State Examination ≥ 18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS).ResultsThe number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel‐Haenszel test = 6.497, df = 1, p = 0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel‐Haenszel test = 4.726, df = 1, p = 0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis).ConclusionsHead Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations. Copyright © 2004 John Wiley & Sons, Ltd.
Differential age‐related change of prose memory in older Hong Kong Chinese of higher and lower education
Authors: Lee T. M. C. , Yuen K. S. L. , Chu L. W. , Chi I. 
Published: March 2004

AbstractBackgroundMemory difficulty is one of the most common complaints of older people, with or without psychiatric conditions. It is therefore of utmost important to understand how normal ageing process impacts upon prose memory so as to gain insight into ways to differentiate pathological vs normal age‐related changes of the recall of prose observed among older people.ObjectivesTo understand the differential age‐related change of prose memory in older Hong Kong Chinese of higher and lower education.MethodForty‐eight normal, healthy Cantonese‐speaking Chinese were recruited. Seventeen of them were younger, highly educated participants. Among the 31 older people recruited, 19 of them received education comparable with the younger participants and 12 were older people of low education. A prose passage was constructed to measure the different processes of prose memory, including learning efficiency, rate of forgetting, recall accuracy, accuracy of temporal sequence of information recalled, distortions, and recognition memory.ResultsAs expected, ageing affected all the processes of prose memory measured, except the rate of forgetting. Apart from learning efficiency and rate of forgetting, education was observed to modify the effect of ageing on all the processes studied.ConclusionsChanges of prose memory associated with ageing and the differential effect of education on prose recall among older people were discussed. The findings seem to suggest that prose memory is a multifaceted construct. Copyright © 2004 John Wiley & Sons, Ltd.
No effects of a combination of caregivers support group and memory training/music therapy in dementia patients from a memory clinic population
Authors: Berger Gabriele , Bernhardt Tanja , Schramm Uta , Müller Ruth , Landsiedel‐Anders Susanne , Peters Juergen , Kratzsch Tilman , Frolich Lutz 
Published: March 2004

AbstractObjectivesTo evaluate the impact of a combination of caregiver support group and memory training/music therapy in dementia patients on behavioural and psychological symptoms (BPSD) and caregiver burden compared to a control group.MethodEighteen patient‐carer‐dyads in the treatment group and 18 patient‐carer‐dyads as controls were studied in the setting of a memory clinic of a psychiatric university hospital over a period of 2 years. Controls were matched for age, gender, diagnosis, dementia severity, living arrangement and medication. The interventions were conducted once per week for 1 hour run by a clinical psychogeriatric team. Outcome measures were patients' cognitive and functional status as well as BPSD and caregivers subjective burden and depression measured by validated scales. Data were obtained 6, 12 and 24 months after baseline.ResultsThere were no significant differences between the intervention and control group neither after 6, 12 nor after 24 months treatment.ConclusionsThe lack of a positive impact in alleviating caregiver burden or BPSD after intensive psychological interventions may result from extensive care in the routine clinical management including individual counselling for patients and families. The effect of ‘treatment as usual’ needs to be taken into account when comparing an intervention and control group, as well as the dosage of the intervention. Copyright © 2004 John Wiley & Sons, Ltd.
Assessing the cognitive abilities that differentiate patients with Alzheimer's disease from normals: single and multiple factor models
Authors: Ownby Raymond L. , Loewenstein David A. , Schram Lynn , Acevedo Amarilis 
Published: March 2004

AbstractBackgroundUnderstanding the structure of cognitive abilities in Alzheimer's disease (AD) has considerable practical and theoretical importance. Some investigators have argued that a single cognitive process underlies the deficits seen in AD, while others have argued for multiple cognitive processes. As deficits in cognitive abilities may reflect the pathological process or processes occurring in AD, determination of the structure of abilities in AD is important.ObjectivesThe purpose of this study was to assess the utility of single and multiple ability factor models in differentiating patients with AD from normals.ResultsFindings show that although a single factor model accounts for a large part of the variability of a battery of measures used to differentiate patients and normals, a multiple factor model performed substantially better based on multiple fit criteria.ConclusionsAt least in this sample, a multiple ability factor model of cognitive abilities fit data better than a single factor model in differentiating patients with AD from normals. Copyright © 2004 John Wiley & Sons, Ltd.
Efficacy of rivastigmine in subjects with moderately severe Alzheimer's disease
Authors: Burns A. , Spiegel R. , Quarg P. 
Published: March 2004

AbstractBackgroundCholinesterase (ChE) inhibitors are primarily used in the treatment of mild to moderate Alzheimer's disease (AD), but may also be effective in more severe disease.ObjectiveTo evaluate the dual ChE inhibitor, rivastigmine, in more severe dementia.MethodsWe retrospectively analysed pooled data from three randomised, placebo‐controlled, double‐blind, 6‐month trials, involving 2126 AD subjects. Subjects were selected according to baseline Mini‐Mental State Examination (MMSE) score to identify subjects with more severe cognitive impairment (10–12 MMSE points). One‐hundred‐and‐seventeen subjects were included who had been treated with rivastigmine 6–12 mg/day or placebo. The AD Assessment Scale‐Cognitive Subscale (ADAS‐Cog), the MMSE, a six‐item subscore of the Progressive Deterioration Scale (PDS) and the BEHAVE‐AD assessed efficacy. Tolerability was assessed by recording adverse events (AEs) and the relative risk (RR) of discontinuation.ResultsThis group of subjects responded well to rivastigmine. After 6 months, the mean ADAS‐Cog score declined by 6.3 points in the placebo group and increased by 0.2 points in the rivastigmine group (observed cases; p<0.001). Clinical benefits were also observed with the MMSE, the six‐item PDS score and items of the BEHAVE‐AD. Rivastigmine showed the same pattern of AEs as in other studies, but the RR of dropping out due to AEs was lower than in subjects with milder AD.ConclusionCurrent treatment guidelines do not recommend treating individuals with severe AD with ChE inhibitors. However, this retrospective analysis suggests that rivastigmine 6–12 mg/day may benefit subjects with more severe disease, as well as subjects with mild to moderate impairment. Copyright © 2004 John Wiley & Sons, Ltd.
Patient versus informant perspectives of Quality of Life in Mild Cognitive Impairment and Alzheimer's disease
Authors: Ready Rebecca E. , Ott Brian R. , Grace Janet 
Published: March 2004

AbstractBackgroundPrior studies on Quality of Life (QOL) in Alzheimer's disease (AD) have rarely included control participants, or participants with very mild levels of cognitive impairment. Furthermore, there is little data to indicate whether or not mildly impaired patients can provide self‐report QOL data or if informant reports are needed.ObjectivesThis study compared QOL ratings from informants and patients with mild AD (n = 26), Mild Cognitive Impairment (MCI, n = 30), and elderly controls (n = 23).MethodsParticipants (aged 60–91 years) were recruited from an outpatient memory disorder clinic. Elderly controls were recruited from the community. Measures about patients were the Dementia Quality of Life scale, the Neuropsychiatric Inventory—Questionnaire, Instrumental of Activities of Daily Living, and Mini‐mental State Exam. Informant depression was assessed with the Geriatric Depression Scale.ResultsResults indicated that overall patient‐informant agreement for MCI (M=0.24), AD (M=0.48), and controls (M=0.49) did not differ significantly. Self‐reported QOL did not differ significantly across the 3 groups. For caregiver‐reports, QOL in MCI again did not differ from controls but was significantly greater than QOL in AD for 2 of 6 scales, and QOL in controls was greater than AD for 4 of 6 scales. Regression analyses indicated that neuropsychiatric symptoms were the most consistent predictors of QOL.ConclusionsIn summary, informant‐ and self‐perceptions of QOL differed substantially. Results suggest that future investigators should carefully consider gathering QOL information from both informants and patients because they provide unique information regarding patient QOL and, to date, neither source of information has been established to be superior. Copyright © 2004 John Wiley & Sons, Ltd.
Measuring Alzheimer's disease progression with transition probabilities in the Taiwanese population
Authors: Fuh Jong‐Ling , Pwu Raoh‐Fang , Wang Shuu‐Jiun , Chen Yu‐Hsin 
Published: March 2004

AbstractBackgroundThe transition probability of Alzheimer's disease (AD) is defined as the likelihood that the disease progresses from one stage to another in a given time period.ObjectiveTo estimate the separate stage‐to‐stage and stage‐to‐death transition probabilities for Taiwanese patients with AD and to evaluate the hazard ratios of age, sex, behavioral symptoms, and medications on disease progression.MethodWe examined data (severity of dementia, hallucinations or delusions, use of cholinesterase inhibitors [CEIs], survival) in 365 patients with probable AD at baseline and at follow‐Gup (mean ± SD 29 ± 17 months, range 3–109 months).ResultsModified survival analysis revealed that transition probabilities of Taiwanese patients were similar to those of Western patients. The probability of dementia remaining at the same stage was higher in patients taking CEIs than in other. Men had a higher probability of dying in the mild stage.ConclusionTransition probabilities can be used to measure AD progression. CEIs used to treat AD might alter the disease course. Copyright © 2004 John Wiley & Sons, Ltd.
The relationship between cholesterol levels and depression in the elderly
Authors: Ergün U. G. Ö. , Uguz S. , Bozdemir N. , Güzel R. , Burgut R. , Saatçi E. , Akpınar E. 
Published: March 2004

AbstractObjectiveThis study was undertaken to evaluate the possible association between low levels of serum cholesterol and depression in the elderly.BackgroundThe alteration of cholesterol content of synoptosomal membrane in response to low serum cholesterol levels has been shown to decrease the serotonin receptors in depressed patients. Previous studies suggest that low levels of serum cholesterol may be associated with the increased risk of depression in the elderly.Subjects and methodsThis was a cross‐sectional study where 189 subjects over 65 years old of both sexes were enrolled. Serum total cholesterol, HDL‐cholesterol (HDL‐C), LDL‐cholesterol (LDL‐C), and triglycerides were measured. Cognitive functions were evaluated with mini mental state examination survey (MMSES) and depression was assessed with Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID‐I).ResultsOf the 189 subjects, 42 were affected by depression. Low serum cholesterol level (cut‐off ≤160 mg/dl) as well as the levels of HDL‐C, LDL‐C and triglycerides were not associated with depression in older men or women.ConclusionsIn the present cross sectional study, there was no association between depression and low serum cholesterol levels after adjusted for confounding factors. Further studies are needed to clarify this suggestion with larger number of patients. Copyright © 2004 John Wiley & Sons, Ltd.
Delirium among patients with and without dementia: does the diagnosis according to the DSM‐IV differ from the previous classifications?
Authors: Laurila Jouko V. , Pitkala Kaisu H. , Strandberg Timo E. , Tilvis Reijo S. 
Published: March 2004

AbstractBackgroundDifferent diagnostic criteria differ in their capacity to identify subjects as delirious. It is not known how DSM‐IV classification, compared with the DSM‐III, DSM‐III‐R, and ICD‐10, identifies delirium among individuals with and without dementia and whether the symptom profiles differ between these two subgroups.MethodsA cross‐sectional study was performed on patients (age ≥ 70 years) in seven acute geriatric wards (n = 230) and in seven nursing‐homes (n = 195) in Helsinki, Finland. Delirium was diagnosed according to the operationalized criteria according to the DSM‐III, DSM‐III‐R, DSM‐IV, and clinical criteria of ICD‐10. Dementia was defined according to consensus judgment among three geriatricians with concise information including: prior dementia diagnoses, Clinical Dementia Rating Scale, operationalized criteria according to the DSM‐IV, nurses and/or caregivers interviews, and the results of the brain CT/MRI and prior Mini‐Mental State Examination scores, when available.ResultsAccording to the DSM‐III, DSM‐IIIR, DSM‐IV and ICD‐10 criteria of delirium 22.7, 23.5, 25.9 and 14.9% of the demented, and 12.9, 13.5, 23.5 and 2.9% of the non‐demented, respectively, were diagnosed as delirious. In stepwise logistic regression analysis clouding of consciousness, perceptual disturbances, and disorganized thinking were the most significant contributors to delirium diagnosis according to the DSM‐IV among individuals with dementia, whereas perceptual disturbances, motor disturbances, and disorientation were the most significant contributors among those without dementia.ConclusionsDSM‐IV criteria of delirium identify new, often non‐demented, subjects as being delirious, while ICD‐10 is overly restrictive. The symptom profile of delirium was slightly different among individuals with and without dementia. Copyright © 2004 John Wiley & Sons, Ltd.
Topographical disorientation in community‐residing patients with Alzheimer's disease
Authors: Pai Ming‐Chyi , Jacobs W. Jake 
Published: March 2004

AbstractBackgroundBased on the hypothesis that declarative memory and navigation ability depend on hippocampal integrity, and the fact that declarative memory declines early in Alzheimer's disease (AD), the authors suggest that topographical disorientation (TD) will be an early manifestation of AD.Subjects and methodsPatients diagnosed with AD based on DSM‐IV criteria, residing at home, were studied in a clinic at a 1000‐bed referral medical center. Patient characteristics, disease condition, performance on neuropsychological tests, and navigation function were compared between patients with and without current TD. Information regarding the extent and duration of TD and the level of current navigational function were collected during a clinical interview.Results112 patients (61 males and 51 females) with mean age of 74 years and disease duration of 37 months completed the study. Among them, 61 currently experienced TD, 20 had required an escort to their home by others, and 28 had TD as an incipient symptom. Those with current TD tended to have a longer disease duration, required an escort to their home by others, and reported a history of repeated change of residence, TD as an incipient symptom, a restricted spatial range within which they felt comfortable (safety range), and disorientation when they were out of familiar territory. In addition, care‐givers reported a high level of concern for the safety of those with TD when he or she traveled alone.ConclusionTD in community‐dwelling AD patient is common. Caregivers should pay attention to those with longer disease duration and try to avoid changing residence. Developing a brief and valid test for topographical orientation will be helpful for the early detection of TD. Copyright © 2004 John Wiley & Sons, Ltd.
Can we trust depression screening instruments in healthy ‘old‐old’ adults?
Authors: Watson Lea C. , Lewis Carmen L. , Kistler Christine E. , Amick Halle R. , Boustani Malaz 
Published: March 2004

AbstractObjectiveDespite a growing understanding of late‐life depression, few studies focus on the old‐old, those 75 years and over. We wished to characterize depressive symptoms and determine the accuracy of two common screening instruments for major and minor depression in a population of old‐old retirees.MethodsParticipants lived independently in one of two Continuing Care Retirement Communities and volunteered for an in‐home interview about cancer screening attitudes. As part of this baseline interview, they were screened with the Geriatric Depression Scale (GDS) and the Center for Epidemiologic Studies‐Depression (CES‐D) scale. Those agreeing to a second interview received an evaluation using the Structured Clinical Interview for DSM‐IV (SCID‐IV), performed by a geriatric psychiatrist within two weeks of the initial interview.ResultsIn an educated and cognitively intact group of retirees averaging 80 years of age, the GDS and CES‐D performed poorly using standard cutpoints in detecting both major (sensitivity 60% for both) and minor (sensitivity 33% and 50%, respectively) depression. One in five participants had significant depression as confirmed by SCID‐IV evaluation. Twelve percent had major depression and 7% had minor depression. Most participants had their first episode of either after age 60.ConclusionsContrary to most studies evaluating the GDS and CES‐D for accuracy in detecting late‐life depression, these instruments at standard cutpoints performed poorly in this group of healthy older adults. The healthy old‐old may require novel screening interventions to detect clinically significant depression. Copyright © 2004 John Wiley & Sons, Ltd.