bluuebunny/crossref_metadata_2025_split huggingface dataset:
The elderly in long‐term care: 2 — an estimate of misplacement using objective criteria
Authors: Kirk S. , Compton S. A. , Devaney N. , Donnelly C. M. , McGuigan M. 
Published: December 2004

AbstractEight hundred and seventy‐one permanent residents in residential homes (Part III), EMI homes, geriatric hospitals and psychogeriatric wards were examined over a two‐week period and their cognitive and behavioural functions recorded using a reliable and valid questionnaire (CAPE Survey). Objective criteria for placement in each of these four types of unit were selected in advance of the study, using easily available Government and professional guidelines. The residents' data were then analysed to see if they were appropriately placed. A considerable degree of misplacement was found to occur in all types of unit and reasons for this are discussed.
The distribution of services to demented elderly people living in the community
Authors: O'Connor D. W. , Pollitt P. A. , Brook C. P. B. , Reiss B. B. 
Published: December 2004

AbstractOne hundred and sixty demented, community‐resident elderly people were identified by means of a community survey. Subjects who lived alone received home helps and meals‐on‐wheels more often than those who lived with supporters but there were no differences between the two groups with respect to district nursing or day care. Services increased in line with the degree of mental infirmity and nearly all moderately and severely demented people who lived alone were known to at least one service. We suggest that the home help and meals‐on‐wheels services, as presently constituted, may have limited applicability to dependent old people who live with able‐bodied supporters. If services are to provide effective assistance, they may need to adapt their provision to the actual needs of elderly people and their relatives.
Lithium in the elderly: A review with special focus on the use of intraerythrocyte (RBC) levels in detecting serious impending neurotoxicity
Authors: Foster Jeffrey R. , Silver Michael , Boksay Istvan J. E. 
Published: December 2004

AbstractThe elderly are at high risk to develop neurotoxicity in the course of lithium therapy. This is especially true for patients with neurologic or cognitive impairments. This may occur even when lithium treatment is modified to include lower doses and lower target blood levels. The literature is reviewed concerning current uses of lithium in older patients. The rationale for expecting that red blood cell (RBC) lithium levels could have predictive value in the early detection of impending serious neurotoxicity is discussed. There appears to be a critical value for RBC lithium in the region of 0.6 mEq/ 1 that is ominous as a harbinger of impending toxicity. This critical concentration may be considerably lower for patients with dementia.
Environments for the dementing
Authors: Benjamin Lisa C. , Spector John 
Published: December 2004

AbstractThe Multiphasic Environmental Assessment Procedure (MEAP; Moos and Lemke, 1984) was used to assess a British sample of specialized envionments for the dementing and elderly. Results supported the utility of the MEAP as a measurement tool. Shortcomings in the planning for such environments were identified, for example in the provision of adequate safety, prosthetic and orientational aids, and some assumptions about care priorities were challenged, such as the cruciality of ‘integration’ and the necessity for proximity to community facilities of units for the dementing. Comparisons with American normative data were made, with the most consistent finding being a more satisfactory provision of physical environment features in the American sample.
The relationship of staff, resident and environmental characteristics to stress experienced by staff caring for the dementing
Authors: Benjamin Lisa C. , Spector John 
Published: December 2004

AbstractIn a study linked to the examination of the ‘MEAP’ as a measure of environments for the dementing, a procedure for measuring stress in the carers of the dementing was designed and administered to staff caring for the dementing in three different facilities. Stress was attributed primarily to staff, resident, or environmental characteristics. Events were identified to which care staff of the dementing attributed their stress, and variables including types of staff training and experience, levels of dementia in residents and staff levels were discussed as possible contributors to the perception of events as stressful.
Fluency of speech and self‐awareness of memory deficit in alzheimer's disease
Authors: Loebel J. Pierre , Dager Stephen R. , Berg Glenda , Hyde Thomas S. 
Published: December 2004

AbstractAlthough gradual global progression is one of the cardinal features of primary degenerative dementia of the Alzheimer type, clinical observation of patients suggested that there is some variability in the degree and rapidity of decline of different symptoms of this illness. In particular, it appeared that language fluency and self‐awareness of memory problems did not decline simultaneously. This study was designed to test the hypothesis that an inverse relationship exists between self‐awareness and fluency in patients with Alzheimer's disease. Thirty‐two patients suffering from Alzheimer's disease were divided into two groups on the grounds of presence or absence of self‐awareness of memory handicaps. These patients were also assessed in regard to fluency using a three‐point scale devised for this purpose. A significant inverse association was found between self‐awareness and fluency. This appeared to be a specific relationship, unrelated to global indicators of function including Mini‐Mental Status Evaluation, Aphasia Screening Test scores or demographic features. Possible implications of this with reference to intracerebral localization issues in mild‐moderate Alzheimer's disease are discussed.
Functional impairment and behavioural disturibances in vocally disruptive patients in psychogeriatric wards compared with controls
Authors: Hallberg Ingalill R. , Norberg Astrid , Erikson Sture 
Published: December 2004

AbstractThis study aimed at identifying patterns or clusters of functional impairment and behavioural disturbances in vocally disruptive patients compared with controls. Identified vocally disruptive patients (37) from psychogeriatric wards (264 patients) were included and compared with controls (37) matched for sex and wards. Assessment of the degree of orientation and functional performance (physical and psychosocial) was made using a newly developed rating scale, Organic Brain Syndrome Scale, consisting of two subscales, a 16‐item scale measuring orientation and a 39‐item scale measuring functional performance. Principal component analysis was applied reducing the first subscale into three factors (orientation to time, person, past and present events) and the other subscale into seven factors (functional performance and orientation in the ward, fluctuations in mental state and emotional disturbances, speech performance and psychomotor slowing, mobility, hostility, presence of delusions and hallucinations, sensitivity and euphoric state). Discriminant analysis revealed that vocally disruptive behaviour related significantly to physical dependence and disorientation in the ward, confusional reactions, delusions, hallucinations and a more preserved speech performance compared with controls. Suggestions have been made that vocally disruptive behaviour develops when environmental factors such as sensory deprivation interact with the effects of the brain damage.
Quantification of physical illness in psychiatric research in the elderly
Authors: Burvill Peter W. , Mowry Bryan , Hall Wayne D. 
Published: December 2004

AbstractThis article outlines a simple coding matrix for recording physical illness in a compact form suitable for computerization in research. It allows the recording of physical illness in a number of different ways: the particular organ system(s) involved; whether the illness is acute or chronic; the severity of illness; and the severity of interference with daily living. The application of the scheme is shown in a cohort of depressed elderly patients in hospital. Also included were three self‐assessment scales of physical illness and an OARS Physical Health Rating. It was concluded that the simplest and most parsimonious approach to assessing global physical illness for psychiatric research purposes on the elderly would be to (a) measure the number of body system affected by acute and chronic physical illness, and (b) ask each patient to assess his/her own physical health by one appropriate question.
The guy's/age concern survey: Physical health and psychiatric disorder in an urban elderly community
Authors: Lindesay James 
Published: December 2004

AbstractThe associations between physical health problems and cognitive impairment, depression, generalized anxiety and phobic disorders are described in a random community sample of 890 elderly people. 28.4% of the total sample reported one or more serious physical health problems, and increased rates of health problems were associated with cognitive impairment, depression, generalized anxiety and agoraphobia. Particular psychiatric disorders were associated with distinct patterns of specific physical health problems. Self‐reports of physical health problems were associated with worry about physical health, but this did not account for the association between physical health problems and depression and agoraphobia.
A sequential double‐blind controlled study of moclobemide and mianserin in elderly depressed patients
Authors: Tiller John , Maguire Kay , Davies Brian 
Published: December 2004

AbstractMoclobemide was compared with mianserin in a double‐blind controlled study in elderly depressed patients. Sequential analysis of 11 pairs of patients found no significant difference between the drugs at the week 8 analysis. Unpaired comparison of the 26 patients completing four weeks' treatment also showed no significant difference between the two drugs. Both drugs significantly reduced Hamilton and Carroll depression rating scroes. A separate analysis of the 20 patients completing eight weeks' treatment showed that both drugs produced significant decreases in Hamilton and Carroll depression ratings with no significant difference between the two drugs for depression scores at either week 4 or 8. Side‐effects were minimal, with the most severe emergent side‐effects for moclobemide being sleep disturbance, blurred vision and dry mouth.
Hypothesis linking plasticity, vulnerability and nerve growth factor to basal forebrain cholinergic neurons
Authors: Perry Elaine K. 
Published: December 2004

AbstractThe hypothesis is advanced that two striking features of basal forebrain cholinergic neurons (BFCN)—their role in memory and their vulnerability in disease—are related to their dependence on nerve growth factor (NGF). Numerous studies, involving retrograde transport, receptor localization and responses to exogenous growth factor, have demonstrated a relatively selective association of NGF with these neurons in adult brain. The role of BFCN innervating cortical areas such as the hippocampus (and other cortical areas) in memory is widely supported by the results of surgical or pharmacological manipulation in experimental animals. Neuronal degeneration, indicated by decreased cortical cholinergic activity and/or subcortical cell loss, is also evident in a wide variety of cerebral disorders involving memory loss and dementia (Alzheimer's and Parkinson's disease, subacute sclerosing panencephalitis, Lewy body dementia and olivopontocerebellar atrophy are some examples) and to a lesser extent in normal ageing itself, in which memory is particularly vulnerable. Evidence is provided to support the idea that activity‐dependent uptake of NGF underlies both the memory function of BFCN and their susceptibility to disease. It is suggested that therapeutic strategies in dementia may need to be directed towards stimulation (pharmacological or physiological) of surviving BFCN.
The nature of wandering in dementia: A community‐based study
Authors: Hope R. A. , Fairburn Christopher G. 
Published: December 2004

AbstractWandering in dementia causes major difficulties for both patients and their carers. The term ‘wandering’ however, is vague and has no specific meaning. The behaviour of 29 patients in the community with dementia who had been classed as ‘wanderers’ was studied. The subjects were assessed using a semistructured interview with a carer. The findings show that the term ‘wandering’ covers a wide range of distinct behavioural abnormalities. A descriptive typology of wandering is proposed and the rates of each type are given. It is suggested that five fundamental components underlie the various types of wandering.
Zuclopenthixol dihydrochloride in the management of behavioural disorders in elderly demented patients: A dose‐ranging study
Authors: Venkateswarlu Tamirisa , Staley Christopher John , Neal Charles David 
Published: December 2004

AbstractRestlessness, aggressiveness and agitation in elderly people with dementia sometimes requires treatment with drugs. Often patients cannot be calmed by soothing measures alone, and neuroleptics in low dosages are frequently used. This open dose ranging study was proposed to determine the optimum dosage of oral zuclopenthixol for patients with dementia and behavioural problems. Twenty hospital inpatients entered the study of whom 14 were established on a therapeutic dosage (the lowest dose providing maximum clinical benefit without the emergence of unwanted symptoms) and maintained for four weeks. Eleven of the 14 patients who were established on a therapeutic dosage received either 2 or 4mg bd. Patients' symptoms were shown to have significantly improved during the study.
Mental and physical capacity and consumption of neuroleptic drugs in residents of nursing homes
Authors: Nygaard H. A. , Bakke K. J. , Breivik K. , Brudvik E. 
Published: December 2004

AbstractThe mental and physical capacity of all persons living permanently in a nursing home in Bergen were estimated and their neuroleptic drug consumption and duration of stay were registered. Fifty‐one per cent were severely and 14% moderately mentally impaired. Eighty‐seven per cent demanded more extensive nursing care. Physical dependence was significantly associated with mental decline, but not with age. 32.6% received regularly neuroleptic medication, which was most common among restless and wandering residents. Dosage fell with increasing age and decreasing ability to perform personal hygiene.
The case identification of dementia in the community: A comparison of methods
Authors: Brayne Carol , Calloway Paul 
Published: December 2004

AbstractFew studies have compared methods of case identification in dementia in detail. In this epidemiological study of cognitive function and dementia, scales and clinical diagnoses were compared in 365 women aged between 70 and 79. The women were interviewed using CAMDEX (Cambridge Examination for Mental Disorders of the Elderly), which includes established and new scales of cognitive function and behaviour. In addition, the information/orientation subscale of the Clifton Assessment Procedure for the Elderly was recorded. The proportions of the population identified by various recommended cutpoints for these scales were calculated. Sensitivities and specificities for these were compared, using CAMDEX clinical diagnosis as the standard. Large differences were found in these according to both the cutpoint set and the level of dementia examined. Each subject was rated by her own general practitioner and a random 10% of the sample was seen using the Geriatric Mental State Examination in addition to CAMDEX. The different diagnoses were compared and considerable variation found.
A community‐based study of aggressive behaviour in dementia
Authors: Ware Christopher J. G. , Fairburn Christopher G. , Hope R. A. 
Published: December 2004

AbstractAggressive behaviour is a serious care problem for families looking after patients with dementia. The aim of this study was to investigate, in a community sample of patients with dementia, the nature of aggressive behaviour and the settings in which it occurred. Thirty‐seven subjects known to be aggressive were studied. The results show that the acts of aggression can be usefully classified on the basis of the circumstances in which they occur. It is argued that such a classification is likely to be of more value in understanding aetiology than is a classification based on the nature of the acts themselves.
Mortality in relation to dementia, depression and social integration in an elderly community sample
Authors: Jorm A. F. , Henderson A. S. , Kay D. W. K. , Jacomb P. A. 
Published: December 2004

AbstractIn a community sample of 274 persons aged 70 + years in 1982‐83, measures of depression, dementia and social integration made at that time were examined in relation to mortality in the following five years. The probability of death was increased in those diagnosed as having a dementia or a depressive disorder. The association between depression and mortality suggests that there may in such cases be a physical illness accompanied by a drop in mood. Alternatively, the symptoms of depression could also be symptoms of serious medical illness. Other symptoms, typical only of depression, did not predict mortality. There was no association between mortality and social integration, a finding which is contrary to previous observations.
Incidence of depression in a medical long‐term care facility: Findings from a restricted sample of new admissions
Authors: Foster Jeffrey R. , Cataldo Janine K. , Boksay Istvan J. E. 
Published: December 2004

AbstractThe prevalence rate of depression in medical long‐term care facilities is high but varies over a large range. One source of variation may be differences in the underlying incidence rates. A cohort of 104 new admissions was followed for one year and showed and incidence rate of approximately 14%. This rate is comparable to the only other published study and suggests that incidence rates may be more uniform than expected from the range of prevalence reports.
Group living, an alternative for dementia patients. A cost analysis
Authors: Wimo Anders , Wallin Jan Olov , Lundgren Kjerstin , Rönnbäck Eva , Asplund Kenneth , Mattsson Bengt , Krakau Ingvar 
Published: December 2004

AbstractThe increasing number of patients with dementia requires new forms of care management. Group living (GL) is an alternative, and two units were established in Sundsvall, Sweden, in 1984. The patients in GL used institutional care to a significantly lower extent (nursing homes, emergency hospital care, psychiatric care) after admission to GL (p < 0.001). The costs for the Municipality and the County Council changed from £49 to £42/day (p=0.21) and patient during the first six‐month period in GL compared to the six‐month period prior to GL. If the costs for GL are compared to the costs for nursing home care (£68/day), GL is significantly cheaper (p < 0.05).
The impact of a new community mental health team on an inner city psychogeriatric service
Authors: Coles R. J. , Von Abendorff R. , Herzberg J. L. 
Published: December 2004

AbstractThe introduction of a multidisciplinary mental health team for the elderly, providing comprehensive assessment and support for elderly people with mental health problems in an area of inner London, has represented a major change in the way in which psychogeriatric referrals are dealt with locally. The new service replaced a traditional hospital‐based system with a consultant making domiciliary visits. Characteristics of 109 referrals to the consultantbased service over six months are compared to 193 referrals over a similar period following the introduction of the team. Demographic patterns in both groups were similar, as were diagnoses made, with the exception of acute organic confusional states of which a slightly larger proportion were seen under the old service. More detailed assessment of cases and more input both to cases and their carers were possible with a community team. The implications of a community team based service for psychogeriatrics are discussed.
Psychological autopsy of an elderly suicide
Authors: Alexopoulos George S. 
Published: December 2004

AbstractThe case of an elderly woman who committed suicide is presented. Clinical and sociological concepts and empirical findings are discussed in the context of this case. Depression, substance abuse, cognitive dysfunction, exacerbation of preexisting personality disturbance, and medical illness and disability appear to contribute to geriatric suicide in older people. Relocation to a nursing home, while often necessary, has significant emotional value and may function as a precipitant to suicidal behaviour.
Patterns of hearing loss and psychiatric morbidity in elderly patients attending a hearing clinic
Authors: Kalayam Balu , Alexopoulos George S. , Merrell Hal B. , Young Robert C. , Shindledecker Richard 
Published: December 2004

AbstractThis study examines the relationship between hearing loss and psychiatric diagnosis in a geriatric population attending a hearing clinic. Major depression was the most frequent psychiatric disorder and was diagnosed in 30% of subjects. A sensorineural type hearing loss was diagnosed in 85% of the depressed subjects. More hearing loss was seen in subjects with onset of depression after age 55 years, in comparison to geriatric patients with depression onset before age 55 years, subjects with other psychiatric disorders and subjects without a psychiatric diagnosis (p <0.001). The audiogram and speech audiometry suggest involvement of auditory nerve and central auditory pathways in late onset depression.
Subcortical symptoms predominate in vascular dementia
Authors: Wallin Anders , Blennow Kaj , Gottfries Carl‐Gerhard 
Published: December 2004

AbstractThirty‐one patients with the clinical diagnosis of vascualar dementia were examined with regard to symptoms reflecting disturbances in various brain regions. Frontal, parietal, subcortical and non‐regional symptom complexes were used to characterize each patient. Frontal (77%) and subcortical (68%) symptoms were the most common clinical patterns. Using an overall evaluation, subcortical symptomatology was the most prominent clinical picture (45%) Extrapyramidal symptoms, an important aspect of the subcortical symptom complex, were associated with histories of hypertension (p<0.05) and low levels of 5‐hydroxyindoleacetic acid (p<0.05) in the spinal fluid. This study suggests that subcortical, and possibly also frontal, symptoms are typical and perhaps underestimated manifestations of vascular dementia and that they may reflect important pathogenetic pathways in this disorder.
Paranoid features in the elderly with dementia
Authors: Ballard C. G. , Chithiramohan R. N. , Bannister C. , Handy S. , Todd N. 
Published: December 2004

AbstractNinety‐two consecutive psychogeriatric day hospital referrals were assessed using the Camdex schedule. Sixty‐six of the patients had a first‐degree relative visiting more often than once per week and the data from the patient and informant sections of these schedules were analysed to assess the prevalence of paranoid features. Overall, 36.4% fulfilled the modified criteria for paranoid disorder. Significantly more patients with Alzheimer's disease fulfulled these criteria than did those with vascular dementia, and paranoid features were most common in patients with dementia of moderate severity.