bluuebunny/crossref_metadata_2025_split huggingface dataset:
The changing pattern of referrals for psychogeriatric consultation in the general hospital: An eight‐year study
Authors: Anderson David N. , Philpott Robin M. 
Published: December 2004

AbstractAn eight‐year retrospective evaluation of referrals to a psychogeriatric consultation service demonstrated a highly significant linear increase of total referrals with a selective change of case mix that included more depressions and fewer cases of acute confusion or referrals with no psychiatric disorder. This did not occur with referrals from general practice, where case mix remained stable though total referrals also increased. It is suggested that this selective change relates to an educational influence of the specialist consultation service operating within the hospital and represents a desirable change of referral behaviour. The degree of psychiatric morbidity on general hospital wards far exceeds the capacity of a consultationservice whose primary objective must be education to enable non‐psychiatrists to detect and manage the majority of these disorders without recourse to specialist referral. Research that will further define the elements of the educational process that have greatest impactis needed and offers a new research direction for liaison psychiatry of old age.
Stress, role and training in carers of the elderly
Authors: Benjamin Lisa C. 
Published: December 2004

AbstractThe measurement of stressful event frequencies among different long‐stay settings within a hospital for the elderly showed that staff with higher‐ranking roles, regardless of their training, experienced certain stressful events more frequently than other staff members. Stressful event frequencies for a unit with only untrained care staff did not differ from frequencies for wards of trained nurses.
Recurrent herpes zoster encephalitis: A case report
Authors: Medcalf Pippa , Windsor Angus 
Published: December 2004

AbstractAn 89‐year‐old lady presented with severe right‐sided ophthalmic herpes zoster infection and secondary bacterial infection. Two weeks after admission she became very unwell with confusion and drowsiness and later developed bilateral upgoing plantar reflexes. An EEG was highly suggestive of herpes encephalitis and she made a good recovery with acyclovir. Neuropsychological tests showed pathological signs of impaired left temporal lobe function. After a further three weeks she again developed symptoms and signs of herpes zoster encephalitis and a repeat CT scan showed a right internal capsule infarct had developed. Encephalitis after herpes zoster infection is a rare complication but possibly underreported due to difficulties in diagnosis.
Major depression in hospitalized medically ill older men: Documentation, management, and outcome
Authors: Koenig Harold G. , Goli Veeraindar , Shelp Frank , Kudler Harold S. , Cohen Harvey J. , Blazer Dan G. 
Published: December 2004

AbstractFifty‐three hospitalized elderly men with medical illness were diagnosed with major depressive disorder and followed up for a mean of 2.3 months. Documentation and management of the depression by medical housestaff during the followup period were examined. There was no note of depression in the medical records of 44% of depressed patients, and depression was on the active problem list of only 32%. Followup and management plans for the depression after discharge were documented in 29%. No form of treatment was prescribed for 44% of depressed patients. Outcomes were determined by psychiatric evaluation at the end of the followup period. Of the 33 patients still alive and evaluated at followup, 64% had persistent depression, 18% improved, and 18% were in complete remission. No baseline patient sociodemographic or health characteristic, including severity of depression, was significantly related to improvement. Likewise, neither extent of documentation nor treatment implemented by housestaff was a significant predictor of outcome. We conclude that serious clinical depression in medically ill older patients may persist for a considerable period after hospital discharge and neither detection nor current management strategies appear to have a major impact on outcome.
Violence and psychogeriatric inpatients
Authors: Shah A. K. 
Published: December 2004

AbstractThe characteristics of all the patients admitted to an acute psychogeriatric admission ward over a 24‐month period were examined. The patients who had been responsible for acts of violence on the ward were compared with those who had not. Violent patients were likely to be younger, not to be depressed, to have dementia, and to be discharged to a more dependent setting, particularly a long‐stay psychogeriatric ward. The implication of this for adequate provision of psychiatric and social services is discussed. Levels of violence were low with only a small number of patients exhibiting violent behaviour.
Language assessment in a memory clinic
Authors: Stevens Susan J. , Pitt Brice M. N. , Nicholl Claire G. , Fletcher Astrid E. , Palmer Alison J. 
Published: December 2004

AbstractThe article discusses the potential of three assessments of language function in the diagnosis of early dementia. Seventy patients (mean age 68.0 yr) attending a memory clinic were assessed using three language tests: the Boston Naming Test, a semantic, and a phonemic word fluency measure. Results of these assessments were compared with those of clinical diagnosis including the Mini‐Mental State Examination. The patients were classified by probable diagnosis as (i) dementia (N=23), (ii) minimal cognitive impairment (N=18) and (iii) other, mainly depression (N=29). Of the 23 patients in the dementia group, 18 (78.%) had a deficit on the Boston Naming Test, while only 11 (47.8%) were classified as demented on the Mini‐Mental State Examination using a cut point of <24. Nine of the 18 patients (50%) with minimal cognitive impairment had a deficit using the Boston Naming Test, while one did using the Mini‐Mental State Examination. Factors such as age, sex and language of origin, which may have influence on language performance, are discussed. Age did not affect performance, but sex and language of origin did appear to. It is concluded that there is evidence for the inclusion of certain semantic language tests in any assessment of early dementia.
Consumption of psychotropic drugs in elderly persons registered at the home nursing centre in Bergen, Norway
Authors: Nygaard Harald A. 
Published: December 2004

AbstractThe regular use of psychotropic drugs in all patients aged 70 yr and over who were registered at the home nursing centre was studied. 27.4% of the patients used psychotropic drugs, 11.9% used antipsychotics, 14.6% anxiolytics and hypnotics/sedatives and 6% antidepressants. The use of antipsychotics was increased in mentally impaired patients and in wandering, restless aggressive persons, but declined with increasing age. Anxiolytics and hypnotics/sedatives and antidepressants were more frequently used by apathetic/passive/anxious patients. The dosage of antipsychotics declined with age. The doses are usually in line with general suggestions. Drugs in which the efficacy is judged by the patients themselves seem to be taken in higher doses than drugs in which the efficacy is determined by the physician.
Cognitive improvement following benzodiazepine discontinuation in elderly nursing home residents
Authors: Salzman Carl , Fisher Janina , Nobel Kenneth , Glassman Randy , Wolfson Abbie , Kelley Margaret 
Published: December 2004

AbstractIn a controlled study, benzodiazepine treatment was gradually discontinued from a group of elderly nursing home residents. In comparison with similar residents who continued on benzodiazepines, measures of memory and cognitive functioning showed significant improvement following discontinuance. There was no associated increase in anxiety, agitation, or sleeplessness. These data are consistent with previous observations suggesting that benzodiazepines impair cognitive function in the elderly and further indicate that such impairment is reversible upon benzodiazepine discontinuance.
Serum levels of tacrine in relation to clinical response in Alzheimer's disease
Authors: Eagger Sarah , Levy Raymond 
Published: December 2004

AbstractThe relationship between the serum concentrations of tacrine (tetrahydroaminoacridine), two of its metabolites and age, sex and therapeutic effect was examined. The improvement in two measures of cognitive function previously reported to show significant changes with the drug (MMSE and AMTS) correlated with blood levels to a modest but significant degree. Age was associated with higher levels of the drug and of its metabolites but there were no differences between males and females on any of the variables examined. The dose required to achieve adequate levels and therapeutic change is estimated to be at least 125 mg of tacrine hydrochloride or 100 mg of the active base. It is suggested that the full therapeutic value of the drug cannot be estimated at doses much below this and that this might explain some of the discrepant results reported in the literature.
The quantification of the relative effects of age and NART‐predicted IQ on cognitive function in healthy old people
Authors: Starr John M. , Whalley Lawrence J. , Inch Susan , Shering P. Anne 
Published: December 2004

AbstractThe cognitive function of 598 healthy old people aged 70 years or over resident in the community was measured by Mini‐Mental State Examination (MMSE) and National Adult Reading Test (NART). The 598 subjects, who were asymptomatic and on no medication, showed no significant correlation between age and NART‐predicted intelligence quotient (NARTIQ), but there were significant correlations between both age and MMSE score and NARTIQ and MMSE score. These cross‐sectional data suggest that the rate of decline of cognitive function may be significantly greater in subjects with lower NARTIQs; however, longitudinal data are required to test this hypothesis. The provision of normative data from a substantial number of community‐resident old people should assist later studies designed to detect the precise effects of cerebral pathology or systemic disease on cognitive function in old people.
Learning processes in dementia
Authors: Wertheimer J. , Boula J. G. , Brull J. , Gut A. M. , Pierrehumbert B. , Rufini J. , Zinder M. , Brechbühl D. , El Nadi A. , Mouflin A. , Montangéro J. 
Published: December 2004

AbstractIn its broadest sense, learning is a form of adaptation which continues throughout life; a process through which individuals are able to provide adequate responses. Dementia, however, generates a process of unlearning as well as an alteration of the capability to acquire new knowledge. Among the classical theories of learning, genetic psychology seems to be the one that is best suited to provide an understanding of how demented patients use their altered intellectual tools in an effort to master the reality of a world that escapes them. From this perspective, the observations of these patients permit a distinction of five classes of spontaneous activities. Moreover, this theory is helpful in understanding the patient's movements in space, no longer represented internally as a global entity. In occupational therapy workshops, the analysis of the tasks proposed to patients reveal two types of learning, one in which the repetition of the elementary actions is the only causal link with the construction of the object, the other in which a causal sequence of several stages of activity is necessary to reach this goal. Furthermore, within the framework of this theory, it is possible to identify the support necessary to carry out the objectives, in spite of the memory deficits. The social interaction between two patients jointly solving the same task seems to favour learning. Thus, learning remains possible, inasmuch as the channels still open are detected and the ways to use them are defined.
The role of two major cholinergic systems in memory acquistion and retention in the eight‐arm radial maze
Authors: Yamasaki Ritsu , Yamashita Motoshi , Taguchi Koshiro , Okada Michiyuki , Ikeda Hisao 
Published: December 2004

AbstractThe role of the nucleus basalis magnocellularis (NBM) and the medial septum (MS) in postoperative memory acquisition and postoperative memory retention was assessed in the eight‐arm radial maze task (Olton). NBM lesions and MS lesion significantly decreased choline acetyltransferase (CAT) activity in the innervated areas. Animals with MS lesion, but not NBM lesions, showed significant impairment of memory acquisition. NBM lesions induced a unique strategic pattern, but the development of strategic pattern with training was comparable to the sham‐injected group. Animals with MS lesion did not develop strategic pattern with training. NBM and MS lesions did not influence either memory retention or developed strategic pattern. These results suggest that (1) MS contributes to the radial maze task; (2) the two systems have qualitatively different contributions in the radial maze task; (3) the two systems do not contribute to memory retention; (4) the two major cholinergic systems have different functions in the pathophysiology of Alzheimer's disease.
The response of elderly community residents to request for brain donation: An interim report
Authors: Beardsall Lynn , Barkley Claire , O'Sullivan Angela 
Published: December 2004

AbstractNormal neurohistology of the elderly brain is largely unstudied and unknown. Normal brains are essential as controls for postmortem investigations in longitudinal, prospective studies which aim to document and clarify the natural history of Alzheimer's disease. Ethically, consent should be sought from these subjects and their relatives at the beginning of such studies. This article reports the responses of normal and demented elderly community residents to request for brain donation. Eighty‐five per cent of the normal control group and 83% of incident cases of dementia signed declarations of intent for postmortem. During the first year of brain collection, 24 of 33 donated brains have been successfully collected at postmortem. The responses and attitudes of the subjects and their relatives and the value of obtaining such consent are discussed.
An observational study of two long‐stay psychogeriatric wards
Authors: Ward Tony , Murphy Elaine , Procter Andrew , Weinman John 
Published: December 2004

AbstractPatients on two long‐stay psychogeriatric wards were observed using a schedule derived from transcription of videotape filmed on the wards. Data were also collected using the Clifton Assessment Procedures for the Elderly Behaviour Rating Scale (CAPEBRS), the Brighton Clinic Adaptive Behaviour Scale (BCABS) and psychiatric ratings. The observational procedure proved highly reliable but there was little evidence of association with other measures. Items related to disturbed behaviour on the CAPEBRS and the BCABS aggression subscale proved unreliable and it is suggested that this may be due to the overall low levels of activity. The implication for future research are discussed.
Lewy bodies in psychiatric patients
Authors: Birkett D. Peter , Desouky Abdellatif , Han Luke , Kaufman Mavis 
Published: December 2004

AbstractThis investigation concerns the mental changes associated with Lewy bodies. Lewy bodies are inclusion bodies found in nerve cells and are characteristic of idiopathic Parkinson's disease. It has also been suggested that they may occur as a normal ageing change. Previous literature concerning the psychiatric symptoms of Lewy body disease is reviewed. Dementia and parkinsonism‐associated depression have been previously recognized. For this study the psychiatric histories of two groups of autopsied mental hospital patients were compared; one group with Lewy bodies, and one group without Lewy bodies. There were 212 autopsies. Of these, 15 had Lewy bodies and 197 did not. Clinical and neuropathological descriptions of those with Lewy bodies are given. Findings are also presented in tabulated form, and the groups are compared statistically. Clinical diagnosis of Parkinson's disease and admission with a paranoid diagnosis were the findings most associated with Lewy bodies. It is suggested that paranoia may sometimes be an early symptom of Lewy body disease. The problem of patients with psychosis who subsequently develop idiopathic Parkinson's disease is discussed. Such patients could be misidentified and mistreated because of being diagnosed as drug‐induced parkinsonism.
Wechsler intelligence scale profiles in Alzheimer type dementia and healthy ageing
Authors: Christensen Helen , Mackinnon Andrew 
Published: December 2004

AbstractMeta‐analytic techniques were used to integrate the Wechsler Adult Intelligence (WAIS) scores of healthy elderly subjects and Alzheimer type dementia patients from 21 studies. Although age‐scaled scores for demented subjects were lower than those of healthy elderly subjects for all subtests, the profiles for both groups were essentially parallel, with no subtest having significantly poorer scores than the others for the dementia patients. The pattern confirms other findings that verbal tests do not ‘hold’ to a greater degree than performance tests in dementia.
The St George's dementia investigation bed: A study of factors influencing the agreement between clinical and pathological diagnosis
Authors: Gilleard C. J. , Kellett J. M. , Millard P. H. , Wilkins P. , Honavar M. , Lantos P. L. 
Published: December 2004

AbstractAccurate diagnosis in life of the underlying pathology in the dementias of old age remains difficult despite improvements in the specification of diagnostic criteria. The present study sought to determine the influence of age, comprehensiveness of investigations, severity of dementia and length of delay between investigation and autopsy on the level of clinicopathological diagnostic accuracy achieved. We were unable to identify any single factor which significantly enhanced or impaired overall diagnostic accuracy.
A behavioral microanalysis of the effects of haloperidol and oxazepam in demented psychogeriatric inpatients
Authors: Burgio Louis D. , Reynolds Charles F. , Janosky Janine E. , Perel James , Thornton Joe E. , Hohman Mary Jane 
Published: December 2004

AbstractTwenty‐one inpatients on a psychogeriatric unit were assigned randomly to a haloperidol or oxazepam treatment group. Drug effects were assessed with three psychiatric rating scales and direct behavioral observation. The behavioral microanalysis employed two separate systems of observation: aberrant behaviors were assessed by recording the frequency of behaviors per hour, and the activities assessment (eg social interaction, sleeping) sampled each resident's behaviors during two 10‐min intervals per day. Results showed no differences between drug groups on any of the assessments, except for engagement in activities from the activities assessment. A modest non‐significant decrease in symptoms was noted on all psychiatric assessments. The behavioral observations showed very low pretreatment levels of aberrant behaviors. Non‐significant post‐treatment decreases were observed for disruptive vocalizations, paranoid verbalization, and non‐compliance; rates of physical aggression and psychomotor agitation increased somewhat. The potential role of behavioral microanalysis in nursing homes is discussed in light of new HCFA guidelines.
Differentiation between organic and functional psychiatric illness in the elderly: An evaluation of four cognitive tests
Authors: Orrell Martin , Howard Robert , Payne Andrew , Bergmann Klaus , Woods Robert , Everitt Brian S. , Levy Raymond 
Published: December 2004

AbstractOne hundred and sixty‐four patients admitted to a psychogeriatric unit were given a combination of four different cognitive tests: the Mini Mental State Examination (MMSE), the Abbreviated Mental Test Score, The Felix Post Unit Score and the compilation of tests recommended by the MRC Alzheimer's Disease Workshop. The tests were compared with respect to their ability to sort accurately cases of dementia and depression, and the effects of age and education on test score and misclassification rate with diagnosis controlled for. The MMSE had a very high misclassification rate for the poorly educated and depressed group. The logistical discriminant functional analysis selected only eight items as the best discriminators between organic/ functional or dementia/depression groups. Only one of these eight was not either a memory or orientation test. The value of simply adding up tests of different aspects of cognitive function in dementia assessment or screening is questioned.
The possessions owned by long‐stay psychogeriatric patients
Authors: Mountain Gail , Bowie Peter 
Published: December 2004

AbstractA survey of patients' property and clothing was carried out on 11 long‐stay wards for the elderly confused in one health district. The results revealed a significant variance across the wards for both possessions and clothing. The potential effects on patient ownership of patient sex, physical dependency, availability of storage facilities, ward relocation and the practices of the staff are discussed.
Psychiatric morbidity among people aged 85+ in 1987. A follow‐up study at two and a half years: Associations with changes in psychiatric morbidity
Authors: Bowling Ann , Farquhar Morag , Grundy Emily , Formby Juliet 
Published: December 2004

AbstractThis article reports findings from a longitudinal survey of very elderly people living at home in London. The research aimed to identify social, psychological and physical characteristics associated with positive ageing and successful survival in the community in later life and its converse—negative ageing—as well as the associated policy implications. Associations with psychiatric morbidity, measured using the General Health Questionnaire, among sample members without cognitive impairment between the baseline interviews in 1987 and at follow‐up, two and a half years later in 1990, are reported. Twenty‐five per cent of survivors scored over the threshold of the GHQ in 1987 and 30% scored over the threshold in 1990. Half of those with a score over the threshold in 1990 also scored over the threshold in 1987. Hierarchical regression (using residualized change analysis) was used to estimate the effects of the independent variables on changes in psychiatric morbidity. The most significant predictor of psychiatric morbidity (GHQ score) in 1990 was baseline GHQ score, followed by health and functional status scores. Health and functional status were also the strongest predictors of baseline (1987) GHQ scores. The uniqueness of the study lies in the collection of follow‐up data on a sample of very elderly people, given that most surveys are corss‐sectional and contain too few people aged 85+ to merit separate analysis. It contributes to the small body of literature on outcome of depression. The lack of consistent associations with recovery from psychiatric morbidity in the literature enhances the importance of studies aiming to identify factors associated with different outcomes.
Psychotic symptoms in Alzheimer's disease
Authors: Jabeen Sabiha , McKeith Ian G. , Fairbairn Andrew F. , Perry Robert H. , Ferrier I. Nicol 
Published: December 2004

AbstractThe case notes of 37 patients with neuropathologically confirmed Alzheimer's disease were studied for non‐cognitive psychiatric features occurring during the course of the illness. Four (11%) exhibited delusions, five (14%) had visual hallucinations and one (3%) had auditory hallucinations. Two (6%) developed a misidentification syndrome, five (14%) developed non‐delusional paranoid thinking and six (16%) had significant depressive symptoms with two (5%) developing major depression. Possible explanations for the wide variation in reported rates of psychotic symptoms in Alzheimer's disease in the literature are discussed.