bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuropsychological markers of dementia in patients with memory complaints
Authors: Guarch J. , Marcos T. , Salamero M. , Blesa R. 
Published: March 2004

AbstractObjectivesTo identify neuropsychological markers able to predict evolution towards dementia, through the detection of differential neuropsychological characteristics in a group of subjects complaining of memory loss, in a longitudinal, two‐year follow‐up study.MethodsLongitudinal and retrospective comparisons of neuropsychological performance in: (a) subjects complaining of memory loss who, after a two‐year period, met neurological and clinical diagnostic criteria for probable AD, and (b) subjects from the same group who did not progress towards dementia. A sample of 43 subjects were administered a comprehensive neuropsychological battery evaluating orientation, logical‐verbal and visuoperceptive reasoning, immediate and delayed verbal and visual memory, attention, learning, executive functions and semantic and phonemic verbal fluency.ResultsOf the 43 subjects evaluated and then re‐evaluated two years later, ten (23%) progressed to dementia according to the NINCS‐ADRDA criteria for probable Alzheimer's disease. The neuropsychological performance of the rest of the subjects (n=33) over the two examinations was stable. In the retrospective analysis the principal differences between the two groups were found in the intensity of the initial memory deficits (WMS‐R) and in the impairment of other cognitive areas in the dementia group: formation of concepts, vocabulary and similarities (WAIS), learning (WMS‐R) and several executive functions.ConclusionsThe deficits in cognitive areas other than memory are significant in subjects with memory complaints who progress towards dementia within two years. Memory complaints represent a risk factor that is at least as important as actual memory loss. Recent proposals for adding descriptive labels to the diagnosis of Mild Cognitive Impairment (MCI) in order to reflect the neuropsychological functions impaired in addition to memory (Petersen, 2001a), may be decisive from the prognostic viewpoint. Copyright © 2004 John Wiley & Sons, Ltd.
The Revised Kingston Standardized Cognitive Assessment
Authors: Hopkins Robert W. , Kilik Lindy A. , A. Day Duncan J. , Rows Catherine P. , Hamilton Pamela F. 
Published: March 2004

AbstractThe original Kingston Standardized Cognitive Assessment (KSCA) was designed to assess cognitive functioning in the elderly with suspected organic brain damage (i.e. dementia). It was specifically designed to be a relatively quickly administered assessment tool available to mental health professionals who were not trained in specialized cognitive assessment techniques. It was introduced over a decade ago to bridge a gap between brief, narrowly focused rating scales, and intensive, expensive, full neuropsychological assessments. Recently, a revision of the KSCA was completed. This revision includes the addition of a word‐list memory task with immediate recall, delayed recall and recognition formats, as well as new norms for patients with Alzheimer's disease (AD). The updated norms reflect the abilities of higher‐functioning (community‐dwelling) patients. In order to facilitate the Revised KSCAs use we have developed a new scoring and analysis form as well as a more comprehensive scoring and administration manual. These changes have resulted in better detection of earlier Alzheimer's disease and use of comparison groups that reflect the changing referral base. The structure of the revised scale and updated normative data are described. An illustrative clinical case example is also provided. Copyright © 2004 John Wiley & Sons, Ltd.
Syndromes of behavioural and psychological symptoms in mild Alzheimer's disease
Authors: Moran Maria , Walsh C. , Lynch A. , Coen R. F. , Coakley D. , Lawlor B. A. 
Published: March 2004

AbstractObjectivesBehavioural and psychological symptoms of dementia (BPSD) are common in Alzheimer's disease (AD), and are associated with significant distress for patient and carer. Certain behavioural and psychological symptoms have been associated with each other, leading to the suggestion that differences in symptom patterns among patients with AD may represent different syndromes within AD. The purpose of this study is to see if patients with AD could be meaningfully classified into syndromes, based on the relationships between their BPSD.MethodologyThe sample was recruited through a memory clinic. Two hundred and forty first visit patients with a diagnosis of very mild to mild AD were included. BPSD were assessed using the BEHAVE‐AD. Latent class analysis was used to assess for different classes or groups of patients within the sample, based on their behavioural and psychological symptoms.ResultsThree classes were identified; Class 1 with a low prevalence of behavioural and psychological symptoms; Class 2 an anxiety/depressive symptom class and Class 3 an aggressive symptom class.ConclusionsThe three classes (or groups) of patients obtained by LCA in this sample may be explained by a ‘latent’, as yet, unidentified factor. Further research is required to determine if these classes are stable over time, and to identify possible latent variables. Copyright © 2004 John Wiley & Sons, Ltd.
Life long changes in cognitive ability are associated with prescribed medications in old age
Authors: Starr John M. , McGurn Brian , Whiteman Martha , Pattie Alison , Whalley Lawrence J. , Deary Ian J. 
Published: March 2004

AbstractObjectivesTo determine the association between prescribed medication and life long changes in cognitive ability.DesignRetrospective cohort study.SettingCommunity residents of a largely urban region of South East Scotland.ParticipantsFour hundred and seventy‐eight survivors of the 1932 Scottish Mental Health Survey (n=87 498) without dementia.MeasurementsThe Moray House Test (MHT) of intelligence administered at age 11 and age 80 years. Hospital Anxiety and Depression Scale (HADS) score, history of disease and current prescribed medications age 80 years.ResultsAfter adjusting for sex, neuroactive drugs had a detrimental effect on life long cognitive change age (F=12.2, p=0.001, partial eta‐squared=0.026), statins a beneficial effect (F=5.78, p=0.017, partial eta‐squared=0.013) and polypharmacy a detrimental effect (F=6.46, p=0.011, partial eta‐squared=0.014). In the optimal model estimated marginal means revealed: a relative improvement for statin users, IQ age 11=93.2 (95% CI 87.9–98.4) and age 80=100.6 (95% CI 95.3–105.9); compared with non‐users, IQ age 11=100.9 (95% CI 99.4–102.3) and age 80=100.0 (95% CI 98.6–101.5).ConclusionsClinically, the degree to which drugs impair cognition in relatively fit, older people may not be apparent. However, in population terms, medication use, particularly polypharmacy, is important. Statins, used as currently indicated for cardiovascular disease, appear promising in ameliorating cognitive decline in older people. However, firm recommendation of their use should await the outcome of ongoing randomised clinical trials. Copyright © 2004 John Wiley & Sons, Ltd.
Pentagon drawing and neuropsychological performance in Dementia with Lewy Bodies, Alzheimer's disease, Parkinson's disease and Parkinson's disease with dementia
Authors: Cormack Francesca , Aarsland Dag , Ballard Clive , Tovée Martin J. 
Published: March 2004

AbstractObjectivesEarly and accurate diagnosis of Dementia with Lewy Bodies (DLB) to allow the appropriate clinical treatment is a priority, given reports of severe neuroleptic sensitivity and a preferential response to cholinesterase inhibitors in these patients. There have been suggestions that constructional apraxia is prevalent in DLB, and may provide a sensitive marker of the disease.MethodsThis study examined the pentagon drawings of 100 DLB patients, 50 Alzheimer's disease (AD) patients, 81 Parkinson's disease (PD) patients of whom 36 suffered from dementia (PDD). Performance on this task was correlated with cognitive performance on the MMSE and CAMCOG scales.ResultsPatients with DLB were found to draw significantly worse pentagons than those with AD or PD, but not those with PDD. Drawing scores were significantly correlated with MMSE scores for the AD and PDD groups but not those with DLB. More detailed analysis of the neuropsychological correlates of constructional performance for patients with AD and DLB, revealed that those with AD showed a broad cognitive basis to their impairment, in DLB drawing was linked only to perception and praxis.ConclusionsThis study has suggests that DLB subjects show an impairment of pentagon copying that is dissociable from more global cognitive impairments, whereas PD patients are relatively unimpaired on pentagon copying and AD and PDD patients show a linkage of their impairment in copying with more global cognitive deficits. Copyright © 2004 John Wiley & Sons, Ltd.
The Hopkins Symptom Checklist‐25 is a sensitive case‐finder of clinically important depressive states in elderly people in primary care
Authors: Fröjdh Karin , Håkansson Anders , Karlsson Ingvar 
Published: March 2004

AbstractObjectiveNo depression rating scale has yet been designed to identify all clinically important depressive states in elderly. Therefore, this study investigated the Hopkins Symptom Checklist‐25 (HSCL‐25), a self‐rating scale for depression, to see if it was a sensitive indicator of major, minor and subsyndromal depression.MethodsStructured interviews of 37 people with a high depressive score and an age and sex matched control group comprised of 37 persons with a low depressive score in HSCL‐25, in order to compare the HSCL‐25 ratings with the Montgomery‐ Åsberg‐Depression Rating Scale (MADRS) as well as with the criteria for major, minor and subsyndromal depression.ResultsThe sensitivity for identifying any depression was 94% and the specificity was 94% for HSCL‐25 compared to the diagnostic criteria for depressive disorders.ConclusionsHSCL‐25 is a sensitive case‐finder of any depressive disorder and may be useful in general practice and for screening studies of depression in elderly people. Copyright © 2004 John Wiley & Sons, Ltd.
Do economic cycles have a permanent effect on population health? Revisiting the Brenner hypothesis
Authors: Laporte Audrey 
Published: March 2004

AbstractThe Brenner hypothesis is essentially that economic cycles, characterized by unemployment and fluctuations in per capita income can have profound negative implications for population health. A number of subsequent studies have identified shortcomings in Brenner's model and have reported results that for the most part contradict his results. This paper argues that the failure to account for the time‐series properties (i.e. the potential for unit root behaviour) of macro level data is a key omission in Brenner's and other subsequent studies. To address this omission an error correction model specification was applied to American data for the period 1948–1996. The findings suggest that economic cycles do have a permanent effect on population health. Paradoxically, they also suggest that economic growth and increases in unemployment reduce aggregate mortality risk. A need for measures of economic change that are perhaps more sensitive to the effects of economic cycles on groups that may be at greater risk of unemployment was identified. Copyright © 2004 John Wiley & Sons, Ltd.
Access to physician services: does supplemental insurance matter? Evidence from France
Authors: Buchmueller Thomas C. , Couffinhal Agnès , Grignon Michel , Perronnin Marc 
Published: March 2004

AbstractIn France, public health insurance is universal but incomplete, with private payments accounting for roughly 25% of all spending. As a result, most people have supplemental private health insurance. We investigate the effects of such insurance on the utilization of physician services using data from the 1998 Enquête sur la santé et la protection sociale, a nationally representative survey of the non‐institutionalized French population. Our results indicate that insurance has a strong and significant effect on the utilization of physician services. Individuals with supplemental coverage have substantially more physician visits than those without. While French patients have greater freedom than patients in other countries to choose to see a specialist rather than a general practitioner, we find no evidence that supplemental insurance affects this decision. Copyright © 2004 John Wiley & Sons, Ltd.
Accounting for the cost of scaling‐up health interventions
Authors: Johns Benjamin , Baltussen Rob 
Published: March 2004

AbstractRecent studies such as the Commission on Macroeconomics and Health have highlighted the need for expanding the coverage of services for HIV/AIDS, malaria, tuberculosis, immunisations and other diseases. In order for policy makers to plan for these changes, they need to analyse the change in costs when interventions are ‘scaled‐up’ to cover greater percentages of the population. Previous studies suggest that applying current unit costs to an entire population can misconstrue the true costs of an intervention. This study presents the methodology used in WHO‐CHOICE's generalised cost effectiveness analysis, which includes non‐linear cost functions for health centres, transportation and supervision costs, as well as the presence of fixed costs of establishing a health infrastructure. Results show changing marginal costs as predicted by economic theory. Copyright © 2004 John Wiley & Sons, Ltd.
Scope and scale inefficiencies in physician practices
Authors: Rosenman Robert , Friesner Daniel 
Published: March 2004

AbstractUsing a national data set, this paper looks at the efficiency of physician practices, focusing on scopes of service by comparing single specialty groups and multispecialty groups. An analysis of efficiency using DEA indicates that there are scope inefficiencies from combining different types of providers into a single practice. Most of the inefficiency is due to technical rather than allocative reasons. In addition, we find that larger practices are able to capture efficiencies of scope, but incur inefficiencies of scale. Copyright © 2004 John Wiley & Sons, Ltd.
Impaired and spared cholinergic functions in the hippocampus after lesions of the medial septum/vertical limb of the diagonal band with 192 IgG‐saporin
Authors: Chang Qing , Gold Paul E. 
Published: March 2004

AbstractTo lesion the cholinergic input to the hippocampus, rats received injections of 192 IgG‐saporin into the medial septum/vertical limb of the diagonal band (MS/VDB). The lesions produced near‐total loss of choline acetyltransferase (ChAT)‐positive neurons in the MS/VDB. The loss was accompanied, however, by only partial decreases (to 40% of control levels) in acetylcholine (ACh) release in the hippocampus. Moreover, ACh release in the hippocampus increased when lesioned and control rats were tested on a spontaneous alternation task, indicating that there was significant residual cholinergic function in the hippocampus. The lesions were sufficient to impair spontaneous alternation scores. However, this impairment could be reversed by either systemic or intrahippocampal injections of the indirect cholinergic agonist, physostigmine, providing additional evidence of residual and effective cholinergic functions in the hippocampus of lesioned rats. Moreover, systemic injections of physostigmine at doses that produced mild tremors in control rats led to more severe tremors in the lesioned rats, suggesting upregulation of cholinergic mechanisms after saporin lesions, likely in brain areas other than the hippocampus. Thus, these findings provide evidence for decreases in cholinergic input to the hippocampus accompanied by deficits on a spontaneous alternation tasks. The findings also provide evidence for considerable residual cholinergic input to the hippocampus after saporin lesions of the MS/VDB. Together, the results suggest that 192 IgG‐saporin lesions of the MS/VDB, using methods often employed, do not fully remove septohippocampal cholinergic input to the hippocampus but are nonetheless sufficient to produce impairments on a task impaired by hippocampal lesions. © 2004 Wiley‐Liss, Inc.
Effects of complete immunotoxin lesions of the cholinergic basal forebrain on fear conditioning and spatial learning
Authors: Frick Karyn M. , Kim Jeansok J. , Baxter Mark G. 
Published: March 2004

AbstractAdministration of muscarinic cholinergic antagonists such as scopolamine impairs the acquisition of contextual fear conditioning, but the role of the basal forebrain (BF) cholinergic system in consolidation is unclear. To test the hypothesis that BF cholinergic neurons are critical for acquisition and consolidation of fear conditioning, male Sprague‐Dawley rats with 192 IgG‐saporin lesions of the entire cholinergic BF made either before or after fear conditioning were tested for conditioned fear to context and tone by assessing freezing and 22 kHz ultrasonic vocalization (USV) responses. Spatial learning in a 1‐day water maze task provided a comparison for effects of the BF lesions on fear conditioning. In the test phase, neither pre‐training nor posttraining BF lesions affected freezing to the context or tone. During both training and testing, pre‐lesioned rats were impaired in production of USVs associated with fear. Postlesioned rats emitted fewer USVs only during testing. Acquisition of a spatial water maze task was mildly impaired in lesioned rats, although probe trial and cued performance was unimpaired. Nevertheless, these data suggest that conditioned fear‐induced USVs are more sensitive to the loss of BF cholinergic neurons than is conditioned fear‐induced freezing. The failure of BF cholinergic lesions to impair contextual fear conditioning indicates that scopolamine‐induced impairments in fear conditioning may not be mediated by affecting cholinergic input to the hippocampus and neocortex. © 2004 Wiley‐Liss, Inc.
Path integration in mammals
Authors: Etienne Ariane S. , Jeffery Kathryn J. 
Published: March 2004

AbstractIt is often assumed that navigation implies the use, by animals, of landmarks indicating the location of the goal. However, many animals (including humans) are able to return to the starting point of a journey, or to other goal sites, by relying on self‐motion cues only. This process is known as path integration, and it allows an agent to calculate a route without making use of landmarks. We review the current literature on path integration and its interaction with external, location‐based cues. Special importance is given to the correlation between observable behavior and the activity pattern of particular neural cell populations that implement the internal representation of space. In mammals, the latter may well be the first high‐level cognitive representation to be understood at the neural level. © 2004 Wiley‐Liss, Inc.
Environment‐spatial conditional learning in rats with selective lesions of medial septal cholinergic neurons
Authors: Janisiewicz Agnieszka M. , Jackson Orville , Firoz Elnaz F. , Baxter Mark G. 
Published: March 2004

AbstractCholinergic medial septal neurons may regulate several aspects of hippocampal function, including place field stability and spatial working memory. Monkeys with damage to septal cholinergic neurons are impaired in visual‐spatial conditional learning tasks; however, this candidate function of septal cholinergic neurons has not been studied extensively in the rat. In the present study, rats with selective lesions of cholinergic neurons in the medial septum and vertical limb of the diagonal band of Broca (MS/VDB), made with 192 IgG‐saporin, were tested on a conditional associative learning task. In this task, which we term “environment‐spatial” conditional learning, the correct location of a spatial response depended on the array of local environmental cues. MS/VDB‐lesioned rats were impaired when the two parts of the conditional problem were presented concurrently, but not when one environment had been learned before the full conditional problem was presented. Our findings suggest that cholinergic MS/VDB neurons participate in some aspects of conditional associative learning in rats. They may also shed light on the involvement of cholinergic projections to the hippocampus in modulating and remodeling hippocampal spatial representations. © 2004 Wiley‐Liss, Inc.
Hippocampal activation during transitive inference in humans
Authors: Heckers Stephan , Zalesak Martin , Weiss Anthony P. , Ditman Tali , Titone Debra 
Published: March 2004

AbstractStudies in rodents have demonstrated that the integration and flexible expression of memories, necessary for transitive inference, depend on an intact hippocampus. To test this hypothesis in humans, we studied brain activation during the discrimination of a series of overlapping and non‐overlapping arbitrary visual stimulus pairs. We report that transitive inference about overlapping pairs is associated with right anterior hippocampal activation, whereas recognition of non‐overlapping stimulus pairs is associated with bilateral medial temporal lobe activation centered in the anterior parahippocampal gyrus. We conclude that immediate access to simple stimulus‐stimulus relationships is mediated via the parahippocampal gyrus, whereas the flexible representation of memory requires the recruitment of the hippocampus. © 2004 Wiley‐Liss, Inc.
The inter‐rater reliability of the Japanese version of the Montgomery–Asberg depression rating scale (MADRS) using a structured interview guide for MADRS (SIGMA)
Authors: Takahashi Nagahide , Tomita Kenji , Higuchi Teruhiko , Inada Toshiya 
Published: March 2004

AbstractThe inter‐rater reliability of the Japanese version of MADRS (MADRSJ) was examined using the structured interview guide for MADRS (SIGMA) developed by our group. Two or more psychiatrists attended the systematic interview sessions with each subject to evaluate MADRSJ independently, using SIGMA. A total of 18 interviews was carried out for seven patients with DSM‐IV major depressive disorder. The severity of each item assessed by the raters ranged from 0 to 6 for nine items and from 0 to 4 for one item. The analysis of variance intraclass correlation coefficient inter‐rater reliability values for the individual items carried out by two trained personnel ranged from 0.91 to 1.00, while those achieved by three raters ranged from 0.85 to 1.00. The present results suggest that SIGMA is a potentially useful interview guide for assessing ten symptoms of MADRSJ precisely in patients with a depressive disorder. Copyright © 2001 John Wiley & Sons, Ltd.