bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal shifts in peak daily activity in Alzheimer's disease
Authors: Ghali Laura M. , Hopkins Robert W. , Rindlisbacher Peter 
Published: December 2004

AbstractClinicians caring for Alzheimer patients have observed that some individuals show increased agitation, restlessness and confusion in the late afternoon, evening or at night. This has popularly been named ‘sundowning’ or ‘the sundowning syndrome’. Despite its obvious clinical importance, little research has been conducted to investigate abnormal activity patterns in patients with Alzheimer's disease. In this study, rest–activity patterns were examined using and electronic monitor with a movement sensor. Eighteen patients diagnosed with Alzheimer's disease were monitored for 48 consecutive hours each. Analyses indicated that some subjects showed increased activity around the time of sunset, and that these individuals were most likely to be in the middle stages of the disease. Subjects in the early stages of the disease showed peak activity before sunset, while those in the late stage showed peak activity after sunset. This progressive phase shift with increasing years of illness is a previously unreported phenomenon which may offer an explanation for the ‘sundowning syndrome’.
Time for change—psychiatric morbidity in residential homes for the elderly
Authors: Neville Peter G. , Boyle Ann , Brooke Sara , Baillon Sarah , Scothern Gail , Broome Colin 
Published: December 2004

AbstractPrevious studies of psychiatric morbidity in Local Authority Social Services Part III homes have shown high rates of depression and dementia. Our study of Part III homes in Leicester city shows higher rates and greater severity of dementia than these studies. Eighty‐two per cent were diagnosed as suffering from dementia to some degree and 53% showed severe levels of cognitive impairment and dependency. A rate of depression (17%) was found, lower than in previously reported studies. These results seem to reflect the changing role of Part III homes in service provision for the elderly population.
Evaluation of an italian educational programme for dementia caregivers: Results of a small‐scale pilot study
Authors: Magni E. , Zanetti O. , Bianchetti A. , Binetti G. , Trabucchi M. 
Published: December 2004

AbstractThe study investigates the role of the characteristics of direct caregivers and of their demented relatives in the effectiveness of an educational programme for caregivers. Measures of stress, depression and knowledge of the disease were employed to monitor the effects of an eight‐session programme. Variables related to both the caregiver and the patient were significantly related to the degree of improvement during the course. Our conclusion is that the efficacy of educational programmes is related to caregiver‐patient interaction.
Presenile dementia: Sufferers, carers and services
Authors: Delany Norma , Rosenvinge Henry 
Published: December 2004

AbstractAn extensive search was made for people with presenile dementia (PSD) still under 65 years living in the Southampton Health District. Twenty‐seven sufferers were identified. People with PSD had a high degree of cognitive, behavioural and self‐care disabilities and carers showed considerable stress. Services were received from the old age psychiatry team, and to a lesser extent from social services and the Community Rehabilitation Unit. Community psychiatric nurses were the commonest form of support. The four sufferers in receipt of no services were less impaired. Identified needs included more counselling and advice and specific provision for the more physically active sufferer.
Cognitive assessment and diagnosis of dementia by camdex in elderly general hospital inpatients
Authors: Lázaro L. , Marcos T. , Pujol J. , Valdés M. 
Published: December 2004

AbstractOne hundred and eight patients aged 70 and older randomly chosen from those admitted to the departments of medicine and surgery in a university hospital were examined for dementia by the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) and DSM‐III‐R criteria. Cognitive impairment was assessed by the cognitive section of the CAMDEX (CAMCOG) and the Mini‐Mental State Examination (MMSE). Fifty‐one per cent of the sample met DSM‐III‐R criteria for at least one psychiatric disorder, dementia being the most common (35%). The cut‐off point of CAMCOG (60/61) was more effective (100% sensitivity and 97% specificity) than the cut‐off point of MMSE (21/22) (95% sensitivity and 86% specificity) in detecting dementia, although the optimal cut‐off point of CAMCOG for our sample was lower than that suggested in previous studies.
Ethical issues in research with dementia patients
Authors: Berghmans Ron L. P. , Meulen Ruud H. J. Ter 
Published: December 2004

AbstractThe conduct of scientific research involving dementia patients is an ethically complex issue. Increased insight into the causes and aetiology of this condition can be of paramount importance for future patients and society as a whole. However, the rights and interests of vulnerable and incompetent persons as subjects in research make ethical boundaries imperative. A distinction should be made between research that may directly be of benefit to the subject (therapeutic research) and research in which no direct benefit for the patient can reasonably be expected (non‐therapeutic research). The majority of the research with dementia patients falls within the latter category. Several ethical issues are discussed, and special attention is paid to the ethical justification of non‐therapeutic research involving incompetent subjects suffering from dementia. Five conditions that should be met in order to make this kind of research ethically acceptable are formulated.
Personal history of depression and its appearance in Alzheimer's disease
Authors: Carpenter Brian D. , Strauss Milton E. , Kennedy John S. 
Published: December 2004

AbstractThis review of medical charts explored the prevalence of personal history of depression in two groups of geriatric inpatients with current major depression. One group had concurrent Alzheimer's disease (AD) along with major depression, while the other had major depression without dementia. Patients with major depression and no dementia were nearly three times as likely to have had a depressive syndrome in the past compared to patients with major depression and AD. Most depressed AD patients were experiencing their first episode of depression. This suggests that AD may be a risk factor for the first lifetime occurrence of depression. While the pattern of specific depressive symptoms was similar between groups, patients without AD more often reported symptoms with a substantial cognitive element (eg thoughts of death, worthlessness) and patients with AD demonstrated more non‐verbal manifestations of depression (eg tearfulness, sad face). A diathesis–stress model that takes into account the neuropathological and psychological concomitants of both depression and AD may be a useful framework for understanding how these two disorders influence one another.
Cognitive screening in a population‐based sample of community‐living elderly: Effects of age and education on the construct of cognitive status
Authors: Fisk John D. , Rockwood Kenneth , Hondas Bonnie , Tripp Dean A. , Stadnyk Karen , Doble Susan E. 
Published: December 2004

AbstractThis study examined the measurement properties of a cognitive screening test, the Halifax Mental Status Scale (HMSS), in a population‐based sample of community‐living elderly subjects (N = 361) and a clinic sample (N = 20) of patients with Alzheimer's disease. Receiver operating characteristic analyses yielded estimates of sensitivity and specificity of approximately 90% for this test. Factor analysis confirmed a three‐factor solution for the HMSS. Although both age and education were correlated with the HMSS total score, their relationship to the factor scores differed. Our study shows that comprehensive cognitive status tests do not measure a unitary construct and that adjustment of summary scores for education is unlikely to optimize sensitivity and specificity. In population‐based studies, only those components of a test that reflect education should be adjusted.
Non‐cognitive psychiatric symptoms in vascular and Alzheimer brain disease
Authors: Birkett D. Peter , Agdeppa Julita 
Published: December 2004

AbstractPsychiatric symptoms, other than dementia, are compared in two groups of mental hospital patients who came to autopsy and had complete brain examination. One group had Alzheimer brain changes with no cerebral infarction. The other group had cerebral infarction with no Alzheimer brain changes. Onset with a non‐dementing paranoid illness after the age of 50 was commoner in the Alzheimer group. There was no predominance of affective symptoms in either group. Suddenness of onset of psychosis distinguished the infarct cases, even in cases where there was no neurologically evident stroke, and when there were long time intervals between onset and death. Those destined to suffer Alzheimer brain changes had a less sudden onset, fewer discharges and rehospitalizations and more frequent transition to dementia.§
Assessing response to tacrine using the factor analytic structure of the Alzheimer's disease assessment scale (Adas)—cognitive subscale
Authors: Olin Jason T. , Schneider Lon S. 
Published: December 2004

AbstractA factor analysis of the Alzheimer's Disease Assessment Scale—Cognitive subscale (ADASc), the primary cognitive outcome measure in most clinical trials of drugs for Alzheimer's disease, was undertaken to test whether factor scores are differentially sensitive to change in a placebo‐controlled 30‐week trial of the cholinesterase inhibitor tacrine. The factor analysis identified three factors: language, memory and praxis, a factor structure similar to an earlier report. All three factors showed worsening for placebo patients and improvements for tacrine patients, with significant between‐group treatment effects. None of the factors was significantly more sensitive to change than another, suggesting that tacrine affects a range of cognitive function.
Determinants of the judgement of general practitioners on dementia
Authors: Wind Annet W. , Schellevis FrančOis G. , van Staveren Gerrit , Scholten Rob J. P. M. , Hooijer Chris , Jonker Cees , van Eijk Jacques T. H. M. 
Published: December 2004

AbstractThe aim of this study was to determine whether the judgement of general practitioners (GPs) on dementia conforms to the international concept of dementia. In this cross‐sectional study we related GPs' judgements on dementia to items of the DSM‐III‐R criteria for dementia. Thirty‐six GPs participated in the study, as well as 3731 community‐dwelling elderly subjects. Items of the criteria for dementia were measured independently of the GP judgement, using the Geriatric Mental State Schedule (GMS). The GPs' judgements were related to the three criteria: memory (odds ratio (OR) = 2.1 (95% CI: 1.8–2.4)), other cognitive functions (OR = 1.6 (95% CI: 1.3‐1.9)) and daily functioning (OR = 1.5 (95% CI: 1.3–1.9)). At item level, several relevant items of the criteria were related to the GPs' judgements recall, time orientation, concentration and muddled thinking. In addition, three items of daily functioning demanding cognitive skills (dependency in travelling, using medication and handling finances) were related. The items related to the severity categories of the GPs' judgements reflected the process of progression in dementia. We concluded that GPs conform to the international concept of dementia in their judgement on the presence of dementia, as well as in their categorization of severity.
Memory complaint in attenders at a self‐referral memory clinic: The role of cognitive factors, affective symptoms and personality
Authors: Barker Andrew , Prior Jacky , Jones Roy 
Published: December 2004

AbstractMemory complaint has been shown to be poorly correlated with objective memory performance in non‐demented elderly people. A previous study indicated the possible importance of depression and personality in the presentation of memory complaint in people with mild memory impairment. The present study overcomes some previous methodological limitations and describes memory complaint, cognitive, affective and personality variables in subjects with mild cognitive impairment self‐referring to a memory clinic, with non‐presenting age‐ and sex‐matched community controls. Self‐referrers had a higher original IQ, but no evidence of greater decline in memory despite having more memory complaint. Personality factors were demonstrated to be important alongside affective symptoms in the presentation of memory complaint in these subjects.
Length of hospital stay and the timing of ECT
Authors: Ball C. J. , Fashola Y. , Herzberg J. L. 
Published: December 2004

AbstractThe lengths of stay of patients receiving ECT and medication or medication alone on an acute elderly admission ward were retrospectively compared. The lengths of stay for those who received ECT were significantly longer than for those not receiving ECT. If the ECT was given within 4 weeks of admission, the length of stay was similar to those receiving medication alone. In addition to symptom complexes, the decision to use ECT should take into account the length of the illness. Early ECT may reduce lengths of stay and decrease the likelihood of chronicity.
Family members'perception of the quality of nursing home care
Authors: Grau Lois , Teresi Jeanne , Burton Brenda , Chandler Barbara 
Published: December 2004

AbstractThis study investigated the extent to which factors not directly related to the caregiving situation predicted family members' perceptions of the quality of nursing home care their elderly relative received. A conceptual model based on consumer satisfaction theory was used to test the extent to which factors associated with family members' expectations for care and their emotional response to the nursing home placement predicted perceptions of quality among 452 relatives representing the residents of two skilled care facilities. The entire model accounted for 27% of the variation in quality assessments. Attitudes towards nursing homes in general, length of resident stay and emotional responses to the placement (concern about the race/ethnicity of caregivers, caregiver burden and caregiver emotional distress) were found to be significant predictors of perceptions of quality.
Behavioural complications of dementia—can they be treated?
Authors: Hinchliffe A. C. , Hyman I. L. , Blizard B. , Livingston G. 
Published: December 2004

AbstractSubjects over 65 with DSM‐III‐R dementia and living in the community (with carers) who were General Health Questionnaire (GHQ) cases were recruited. Subjects were assessed using the Mini Mental State Examination and the Geriatric Mental State (GMS). Carers were interviewed using the GMS or the CIS (Clinical Interview Scale). Information was collected on behavioural disturbance in their relatives using the Present Behavioural Examination; the most distressing behaviours were noted. A multidisciplinary team generated an individualized plan aiming to reduce the most distressing behaviours. Couples were then randomized into groups 1 and 2. For group 1, plans were implemented over 16 weeks and they were then reassessed using the same rating scales as before (phase 1). They were followed up a further 16 weeks later to see if the benefits of intervention were sustained (phase 2). Group 2 were assessed after a period as waiting list controls (phase 1). Their plans were then implemented and they were reassessed (phase 2). There was an improvement in carer mental health and in the behavioural difficulties of the person with dementia for group 1; the two measures of outcome were associated. For group 2, there was no improvement in either outcome measure. The findings are discussed in relation to their relevance for clinical practice.
Psychiatric diagnoses, outcomes and lengths of stay of patients admitted to an acute psychogeriatric unit
Authors: Moss Francine , Wilson Brett , Harrigan Susan , Ames David 
Published: December 2004

AbstractOne hundred and ten consecutive patients admitted to an acute psychogeriatric unit were assessed with the Geriatric Mental State Schedule, Assigned a DSM‐III‐R diagnosis and their length of stay in hospital and discharge destination noted. Forty‐two per cent of patients had organic disorders (mainly dementia), 32% had affective disorders (mainly depression) 23% had schizophrenia or a related disorder. The median length of stay was 29 days and bore little relation to diagnosis, age, sex or cognitive function. Patients with an organic mental disorder were more likely to enter long‐term institutional care, but 78% of patients were able to return to the same level of accommodation (own home, hostel or nursing home) that they had occupied prior to admission. On a four‐point non‐blind outcome scale, 86% of patients were rated as improved at discharge.
Postprandial blood pressure changes in geropsychiatric patients
Authors: Vieweg Victor , McRae Barbara , Eldridge Estena , Lewis Robert 
Published: December 2004

AbstractPostprandial hypotension is more common among the elderly than among the young. Complications of postprandial hypotension potentially include falls, fractures and death. We studies 21 ambulatory patients in a university‐affiliated, state‐operated geropsychiatric hospital. Subjects had major psychiatric diagnoses and received vasoactive drugs for those diagnoses. After baseline measurements, study subjects ate lunch within 15 minutes. The next day, we repeated the procedure except that study subjects did not eat lunch until after they completed the protocol. Mean blood pressure progressively dropped during the 45‐minute period following eating with the greatest difference between eating and not eating values occurring at 45 minutes. Our study results more closely approximated the findings in the literature for community‐dwelling elderly than geropsychiatric patients in residential settings. Age alone may explain study differences. Based on our preliminary findings, it may be that major psychiatric illness and/or its treatment do not alter age‐related cardiovascular hemodynamics in geropsychiatric patients compared with their non‐psychiatric counterparts.
Dementia and driving: Results of a semi‐realistic simulator study
Authors: Harvey Richard , Fraser David , Bonner Dierdre , Warnes Anthony , Warrington Elizabeth , Rossor Martin 
Published: December 2004

AbstractThe objective was to assess the performance of patients with dementia on the DRIVAGE semi‐realistic driving simulator task. A study of patients with dementia who were continuing to drive a car at the time of assessment, was undertaken in a specialist Pre‐Senile Dementia Clinic at The National Hospital for Neurology and Neurosurgery and a driving simulator laboratory at King's College, London. It comprised thirteen patients diagnosed with dementia (10 Alzheimer's disease, three focal dementia syndrome), mean age 63 (range 57–71) years. Measured performance was judged by an independent rater, blind to diagnosis and neuropsychological test results, as either normal or poor by comparison with data previously collected on 125 normal older drivers. Secondary performance was assessed from objective performance data generated by the simulator. The performance of seven patients was rated as normal and that of six as poor. The majority with poor performance could only complete two of four driving tasks. The normal group scored higher on the Mini Mental State Examination (24 (21–27) vs 17 (13–22)), were less impaired on neuropsychological testing, particularly tasks assessing performance IQ, and had intact perceptual abilities. The results of the study demonstrate that patients with dementia can retain their ability to perform a driving task. Loss of this ability is broadly associated with progression of the dementia, impaired perception and impairment of non‐verbal intelligence tests. Studies on larger groups of patients in a more comprehensive driving task would be required to demonstrate specific markers of loss of driving ability.
Driving, Alzheimer's disease and ageing: A potential cognitive screening device for all elderly drivers
Authors: Mitchel Rebecca K. , Castleden C. Mark , Fanthome Yvette C. 
Published: December 2004

AbstractTo compare detriments to driving ability related to Alzheimer's disease (AD) and normal ageing, 19 patients with AD and 48 apparently normal elderly subjects were assessed on measures of cognitive ability to drive (Stroke Drivers Screening Assessment—SDSA). The presence of AD could have a large detrimental effect on driving ability, as measured by a battery of cognitive tests known to be related to on‐road driving performance. All of the AD group failed, whereas 48% of the control group failed (mean = 5.09, 95% confidence interval 3.75–6.43; t = 7.59, dƒ = 65, p<0.001). Normal ageing may also have a detrimental effect on driving ability, as a significant negative correlation was found between apparently normal ageing and performance on the battery (r = –0.72, 95% confidence interval –0.6 to –0.8; dƒ = 56, p<0.001). These data suggest that cognitive decline related to AD and normal ageing may render some unsafe to drive, provided that the correlation between the SDSA and on‐road driving skills holds for normal and demented elderly. Further validation of the SDSA is needed but cognitive screening may well be an important tool in deciding about an individual's safety on the road.
Teaching old age psychiatry to medical students in england
Authors: Gregory Carol A. , Dening Tom 
Published: December 2004

AbstractA questionnaire regarding the teaching of old age psychiatry was sent to psychiatrists at teaching hospitals in England. A 53% response was received. Old age psychiatry is usually taught within general psychiatry, though there is frequent collaboration with geriatric medicine. Large numbers of students provide a challenge to this small speciality. More resources including time for teaching appear to be needed. Old age psychiatrists were keen to convey their enthusiasm and highlight the positive aspects of working with the elderly.
Delusional misidentification in association with cortical lewy body disease—a case report and overview of possible mechanisms
Authors: Baldwin Robert C. , Snowden Julie S. , Mann David M. A. 
Published: December 2004

AbstractA patient presented with a Capgras delusion and reduplication of place. At postmortem there were numerous cortical Lewy bodies. This is believed to be the first such case in which these phenomena have been observed in proven cortical Lewy body disease. The clinical and diagnostic features are described and a brief overview of possible explanations for the phenomena discussed.
Morale in old age: Refining the model
Authors: Wenger G. Clare , Davies Richard , Shahtahmasebi Said 
Published: December 2004

AbstractThe literature on morale has identified many variables as correlates. In most instances, relationships have been sought with specific variables without taking into account the possible effects of other factors which may be responsible for the correlation. This article identifies correlating variables identified in a review of the literature and matches most of them with similar variables from a study conducted in North Wales. Bivariate and multivariate analyses are presented in an attempt to create a refinement of the model of morale. In so doing, the authors reduce the number of variables of interest by half and present a refined model which, when all other variables are controlled for, includes: health limited activities; potential carer when ill; support network type; meeting as many people as desired; self‐assessed loneliness; self‐assessed health.