bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insomnia in the elderly : Prevalence, gender differences and relationships with morbidity and mortality
Authors: Brabbins C. J. , Dewey M. E. , Copeland J. R. M. , Davidson I. A. , McWilliam C. , Saunders P. , Sharma V. K. , Sullivan C. 
Published: December 2004

AbstractA sample of 1070 people aged 65 and over living in the Liverpool community was interviewed in 1982/3. Those traced were then reinterviewed 3 years later. Information was collected on the prevalence of perceived insomnia using a community version of the Geriatric Mental State (GMS), which also provided a diagnosis using AGECAT. Thirty‐five per cent reported trouble sleeping, which was twice as common in women as men and was not wholly accounted for by the increased prevalence of mental illness in elderly women. There was no change in prevalence with age, but insomnia was more frequent in the depressed group (70%). Insomnia is more likely with increasing serverity of depression but was also common in the well group and hence is not a specific indicator. No relationship was found between mortality at year 3 and insomnia or hypnotic use at year 0. Use of hypnotics was related to the presence of sleep disturbance, but not to having a psychiatric diagnosis. Medical intervention may be much more successful in reducing the prevalence of benzodiazepine usage than may have been realized.
The effect of demographic and health variables on a modified form of mini‐mental state examination scores in nigerian elderly community residents
Authors: Baiyewu Olusegun , Bella Andrew F. , Jegede R. Olukayode 
Published: December 2004

AbstractA culturally relevant form the Mini‐Mental State Examination was administered to 502 persons aged 60 years and over living in three locations representing rural and urban settings in southwestern Nigeria. Multivariate statistical methods show that variables like sex, age, education and self‐assessed health affect the scores on MMSE. The coefficient alpha for the instrument was low for those with less than complete primary education, but for those with full primary education or more, it gave a value similar to those obtained in some studies in western countries.
Alcohol abuse in an inner city elderly population: The gospel oak survey
Authors: Livingston Gill , King Michael 
Published: December 2004

AbstractOne hundred and seventy‐nine men and 335 women over the age of 65 years, ascertained in a community survey, completed the CAGE questionnaire to detect possible alcohol abuse. Only three subjects were CAGE positive and thus at risk for alcohol abuse. It is concluded that current alcohol abuse does not underlie neuropsychiatric conditions in the elderly and fears of significant rates of abuse in this population are probably unfounded. Further research is necessary.
Physical assaults by psychogeriatric patients: Patient characteristics and implications for placement
Authors: Eastley Rebecca , Mian Ihsan 
Published: December 2004

AbstractThe case notes of 137 patients admitted to a psychogeriatric assessment ward over 12 months were reviewed. The characteristics of patients who were assaultive prior to, or during admission were compared with those who were not. The reported prevalence of assaultive behaviour from the case notes was compared with that from the formal ‘violent incident’ forms. Twenty‐three per cent of the patients had assaulted others prior to their admission, and 23% were assaultive during their admission. Those patients who were assaultive prior to admission were likely to be assaultive during their admission. Assaultive behaviour prior to and during admission was associated with male gender, dementia, and increased age in female patients. Assaults were underreported on the formal ‘violent incident’ forms by nursing staff. Assaultive behaviour prior to admission predicted discharge to a higher dependency setting, but assaultive behaviour during admission did not. The implications of these findings are discussed.
Relocation mortality in dementia: The effects of a new hospital
Authors: Robertson Carol , Warrington Jill , Eagles John M. 
Published: December 2004

AbstractRelocation mortality has been cited as an important factor when considering the placement of elderly patients. This study describes the fate of dementia patients relocated to facilitate the move to a new hospital. Some wards were moved as intact units—that is, the patients were kept together and there was little change in the nursing or medical staff. Two other wards were closed, and these patients were dispersed to several existing and new wards and experienced changes of nursing and medical staff. All patients underwent prerelocation and postrelocation orientation programmes. The mortality figures for the total patient group before and after the relocation do not show any statistically significant increase in mortality postrelocation. However, for wards that were closed and where the patients suffered maximum disruption to patient group and nursing staff, there was a significant increase in mortality rates.
Person and process in dementia
Authors: Kitwood Tom 
Published: December 2004

AbstractOutlines are given of an ‘ethological’ programme of research into the social psychology of dementia in old age. Here the manifestations and progress of a dementing illness are seen to be crucially dependent on the nature of the interpersonal context. The quality of dementia care can be evaluated, including quantitative measures. Earlier conceptualizations of the dementing process were overly deterministic and pessimistic. New challenges are created for service provision and policy.
A critique of current criteria for early dementia in epidemiological studies
Authors: Burvill Peter Walter 
Published: December 2004

AbstractDifferences between age‐associated memory impairment and mild dementia have yet to be clarified. Attempts to validate the diagnosis of mild dementia have raised considerable difficulties in the absence of a ‘gold standard’. Agreed criteria of mild dementia are still lacking. Progressive deterioration of cognition is generally held to be a cardinal feature of dementia. Many of the multiple factors which can impair cognition and give a spurious impression of mild dementia still present major methodological problems. Agreed diagnostic criteria, use of standardized measuring instruments, clinical interview, key informant inquiry and possibly psychometric testing are highly desirable in order to detect early dementia. For epidemiological surveys reliable screening instruments are important. It is concluded that, at present, there are too many fundamental conceptual and methodological problems to be overcome before we can successfully undertake large‐scale community epidemiological studies of mild dementia.
Idiopathic clouding of consciousness—do the patients have cortical lewy body disease?
Authors: Ballard C. G. , Mohan R. N. C. , Patel A. , Bannister C. 
Published: December 2004

AbstractSixteen out of 58 patients assessed at a day hospital for probable dementia fulfilled the study definition for idiopathic clouding of consciousness. These patients were significantly more likely than other patients in the sample to have visual hallucinations, depression, extrapyramidal symptoms and to experience falls. They hence had the same symptom profile as patients described as having cortical Lewy body dementia, an observation supported by the fact that 14 of the 16 fulfilled McKeith's criteria for the aforementioned condition. Fifty per cent of the patients with idiopathic clouding of consciousness had a family history of Parkinson's disease. The implications of the findings are discussed.
A brief cognitive behavioural therapy group for the elderly: Who benefits?
Authors: Leung Sai Ning Mary , Orrell Martin W. 
Published: December 2004

AbstractThis study looks at the efficacy of brief focused cognitive‐behavioural group intervention in the treatment of mood disorders in older adults in different diagnostic groups. At 1‐year follow‐up, out of a total of 27 patients, 70% required no input from the mental health services and also reported that they were ‘recovered’ and functioning well. When separated into two groups according to the diagnoses on DSM‐III‐R, 92% of the major depressive episode (MDE) group in contrast to 50% of the other disorders group were discharged and functioning well. This suggests that selection of patients using the DSM‐III‐R diagnostic method has helped to identify which depressed elderly people benefit most. A tentative link between personality difficulties is proposed as a possible obstacle to therapy.
Empirical evaluation of the ‘Cognitive Difficulties Scale’ for assessment of memory complaints in general practice: A study of 1628 cognitively normal subjects aged 45–75 years
Authors: Derouesné C. , Dealberto M. J. , Boyer P. , Lubin S. , Sauron B. , Piette F. , Kohler F. , Alpérovitch A. 
Published: December 2004

AbstractThe Cognitive Difficulties Scale (CDS, McNair and Kahn, 1984) was used to assess memory complaints in 1648 subjects devoid of severe medical or psychiatric disorder. The subjects, aged 45–75 years, were recruited when visiting their general practitioner. The CDS was well accepted and showed a good and stable factorial structure. A weak correlation was found between CDS score and the results of a short neuropsychological battery. A high CDS score was associated with advancing age, low educational level, and psychological motives for visiting. A reduced 26‐item version is proposed to shorten the time required to fill in the scale.
The elderly chronic schizophrenic inpatient: A study of psychiatric morbidity in ‘elderly graduates’
Authors: Soni Som D. , Mallik Ather 
Published: December 2004

AbstractThis study surveyed all chronic schizophrenic patients from 11 long‐stay wards of a mental hospital. Patients were assessed on a variety of rating scales to assess clinical psychopathology and behaviour. Patients above the age of 65 years were studied in detail and also compared with those under that age living on the same wards. It was found that all the elderly schizophrenic patients in the sample had severe deficits in the form of residual negative symptoms and thought disorder. They had significantly fewer positive but more negative symptoms as compared to a younger sample on the same wards; there was no differences between the groups for affective symptoms or thought disorder. Although there were more males in the sample, no difference was found on any of the parameters between the two sexes. It was concluded that there are significant clinical differences in the ‘elderly graduates’ as compared to younger patients living in an identical environment; such findings could assist managers and administrators in the development of plans for other patients in this age group who are likely to be relocated from psychiatric hospitals in the near future or are already living in the community.
Predictors of nursing home placement in patients with alzheimer's disease
Authors: Haupt Martin , Kurz Alexander 
Published: December 2004

AbstractSixty‐six outpatients with mild to moderate dementia in Alzheimer's disease at baseline were examined twice with an interval of 12 months. Twenty‐two of these patients who were admitted to a nursing home within this period were compared to a group of 44 patients who remained living at home with respect to demographic data, cognitive and physical dysfunction, behavioural changes in daily living and the burden of caregivers. Stepwise discriminant function analysis revealed that older age, global cognitive decline, incontinence, aggression, depression, and the caregiver's wish to leave the care to someone else were predictors for nursing home placement ithin 1‐year follow‐up and correctly classified 82% of the cases. The study indicates that factors predicting nursing home placement in Alzheimer patients are complex, including demographic characteristics, level of cognitive and physical functioning, behavioural abnormalities in daily living, as well as burden of the caregiver, and are consistent with predictors of institutionalization found in healthy elderly individuals.
The behavioural assessment scale of later life (BASOLL): A Description, factor analysis, scale development, validity and reliability data for a new scale for older adults
Authors: Brooker D. J. R. , Sturmey P. , Gatherer A. J. H. , Summerbell C. 
Published: December 2004

AbstractPreliminary data on the Behavioural Assessment Scale of Later Life (BASOLL) (Brooker and Nissenbaum, 1986) are described. The BASOLL is based upon Zarit's Memory and Behavioural Problem Checklist (MBPC; Zarit et al., 1980) and the Blessed Dementia Scale (BDS; Blessed et al., 1968). The BASOLL was administered to a sample of 177 psychogeriatric patients over a period of 2 years during regular clinical practice in outpatient, day patient and inpatient settings. A factor analysis revealed three factors which were named self‐care behaviour, memory and orientation, and challenging behaviour. The similarity with factors derived from Zarit's MBPC is discussed. Summative scales derived from the factor analysis of the BASOLL were internally consistent. Data on test‐retest and interrater reliability are presented which suggest that the scales are reliable. The scales included in the BASOLL were all able to distinguish between patients in day hospital, respite care and continuing care settings. Thus the scales can be said to have good criterion validity for these settings. The clinical development and utility of the BASOLL is discussed.
Late paraphrenia, advanced schizophrenic deterioration and dementia
Authors: Charlesworth Georgina M. , Hymas Nigel , Wischik Claude M. , Hodges John R. , Sahakian Barbara J. 
Published: December 2004

AbstractThis is a report of a clinical case presentation from the Neuropsychiatry Conference held at Fulbourn Hospital, Cambridge on March 13, 1992. The conference, chaired by Dr Nigel Hymas, was asked to comment on the diagnosis of a case first referred during September 1990. A 60‐year‐old man with no previous history of psychiatric illness presented with persecutory ideation, delusions and hallucinations in the absence of cognitive impairment. At the time, the initial tentative psychiatric diagnosis was one of late paraphrenia, but it later became clear that the patient was dementing. Were the paraphrenia and dementia related? If so, how? What was the nature of the dementing illness? Could life‐long personality abnormalities have been the earliest expression of cerebral abnormalities predisposing him to his current illness? Incompatible evidence from clinical features, functional brain scanning and comprehensive neuropsychological testing demonstrates the inadequacy of current diagnostic criteria.
The domus philosophy: A prospective evaluation of two residential units for the elderly mentally ill
Authors: Dean Rachel , Briggs Kate , Lindesay James 
Published: December 2004

AbstractThis article reports the findings of a prospective study of the first year of operation of two residential domus units for elderly people with dementia (domus A) and chronic schizophrenia (domus B). Residents, staff and the process of care were assessed at baseline in long‐stay mental hospital wards, and at 3 months, 6 months and 12 months after the move to a domus. At 12 months, both domuses were providing more policy choice, resident control, provision for privacy and availability of social and recreational activities than a baseline psychogeriatric ward. Residents' cognitive function improved steadily over the follow‐up period in both domuses, significantly so in domus A. There was also some improvement in residents' self‐care (ADL) skills at follow‐up in both domuses. Residents' communication skills were rated as significantly improved by staff in domus A at all follow‐up assessments, and by staff in domus B at 6 months. Compared to baseline, substantially higher levels of activities and interpersonal interactions were observed at follow‐up in both domuses. There was no evidence that staff suffered from low job satisfaction or psychological impairment at either domus.
The costs of domus care
Authors: Beecham Jeni , Cambridge Paul , Hallam Angela , Knapp Martin 
Published: December 2004

AbstractIn this article we examine the costs and certain characteristics of domus care in two facilities. The domuses are registered mental health nursing homes and the charge made to residents covers many of the service needs of residents. All residents are dependent on social security benefits. The two facilities are highly staffed and each client receives between 17 and 25 hours per week of individual, one‐to‐one support. The research uses the Client Service Receipt Interview to gather data which allow measures of costs for all domus residents to be built up. Use of services based outside the domuses was rare, nevertheless a wide variety of professionals visited the domuses. The main service gaps and deficiencies related to day support services and the inputs of GPs. Accommodation (including in‐house services) dominated the aggregate total costs of care (96%). Average total community care cost was £951 per week for current domus A residents and £909 for domus B residents. Although the new service was more costly than the hospitals from which residents came, the results from the outcomes study suggest that domus residents are experiencing a better quality of life than in hospital.
Computerized cognitive examination of the elderly (ECO): The development of a neuropsychological examination for clinic and population use
Authors: Ritchie Karen , Allard Michel , Huppert Felicia A. , Nargeot Christine , Pinek Bojidar , Ledesert Bernard 
Published: December 2004

AbstractThe development of a computerized neuropsychological examination (ECO), designed to evaluate intellectual functioning in elderly populations, is described. The examination is based on clinical and laboratory observations of cognitive functioning in normal and pathological ageing. ECO provides extensive information on attention, memory, and visuospatial and linguistic functioning, and the use of a touch screen permits the recording of reaction time and response delays. Information regarding qualitative aspects of responses is also recorded. The examination takes relatively little time given the extent of the information obtained (approximately 40 min), is highly acceptable to the elderly, and provides qualitative neuropsychological data although administered by lay interviewers. The results obtained by a normaal group of 335 elderly persons aged between 60 and 100 years are discussed in relation to age and education level.
Age of onset and duration of dementia in people with down syndrome: Integration of 98 reported cases in the literature
Authors: Prasher V. P. , Krishnan V. H. R. 
Published: December 2004

AbstractThe published case reports of 98 people with Down Syndrome were studied with respect to the age of onset and duration of clinically diagnosed dementia. The incidence of dementia was unimodal, increasing rapidly from 40 years to a peak of 30% incidence in the fifth decade of life, followed by a further rapid decline. Females with Down syndrome had an earlier onset. Duration of dementia decreased with increasing age of onset for both males and females.
Five‐year prognosis for dysthymic disorder in old age
Authors: Kivelä Sirkka‐Liisa , Köngäs‐Saviaro Päivi , Pahkala Kimmo , Kesti Erkki , Laippala Pekka 
Published: December 2004

AbstractThe 5‐year prognosis for 199 elderly patients (60 yr+) suffering from dysthymic disorder is described. Twenty‐nine per cent of the men and 39% of the women recovered, 26% of both were suffering from depression after 5 years, 9% of both had a possible dementia, 32% of the men and 22% of the women had died and 3% of the men and 5% of the women could not be contacted. The outcome did not differ between the sexes or age groups. A poor prognosis among men was related to a low educational level, a non‐independent previous occupation, the occurrence of depression previously, a high number of hobbies and the following depressive symptoms: initial and delayed insomnia, retardation and psychomotor agitation. A poor prognosis was also found for those whose functional capacities, hobbies or emotional relations with their wives had declined or who had experienced a pulmonary disease or few or no social growth events during the follow‐up. A poor prognosis among women was related to low self‐perceived health, high sum score of the Hamilton Rating Scale for Depression, thyroid disorder and the following depressive symptoms: loss of libido and diurnal variation of symptoms. A poor prognosis was also found for those whose physical health, functional capacities, social participation rate or hobbies had declined or who had experienced a serious disease during the follow‐up. A favourable prognosis was found for women who moved to live alone or became more active in taking physical exercise.
‘Rementia’: Challenging the limits of dementia care
Authors: Sixsmith Andrew , Stilwell John , Copeland John 
Published: December 2004

AbstractDementia is conventionally defined in terms of neurological changes in the brain and an inevitable and progressive decline in the individual's cognitive powers and functional ability. However, this ‘biomedical’ model fails to recognize other important factors within the dementing process, such as the social and care context within which the dementing person lives. It is argued that appropriate care interventions can have a considerable impact on the progress of dementia. Data from an evaluation of three experimental homes for the elderly mentally ill show that some degree of ‘rementia’, the regaining of lost cognitive and functional abilities, is possible for some individuals. This evidence is used to argue for a more positive approach to dementia care.
Physician input into guardianship cases involving the elderly
Authors: Juretic Mark C. , Martin Deandra L. , Taffet George E. , Wilson Nancy L. , Gregory Honorable Patrick , Luchi Robert J. 
Published: December 2004

AbstractThe determination of an elderly person's competence in guardianship decisions rests primarily on the written statement of an examining physician. We evaluated this physican input by retrospectively reviewing 40 competency case files of persons over age 60 from the Harris County Probate Courts. Of the 40 physician letters reviewed: 10 (25%) did not include a medical or psychiatric diagnosis; 37 (92.5%) did not include results of a formal mental status exam; 19 (47.5%) of the letters were essentially unsupported statements of incompetence. Finally, 29 (72.5%) of the cases failed to include a statement on prognosis or potential need for reevaluation. The medical information transmitted to the courts in guardianship cases involving the elderly was inadequate for the courts to make informed decisions. Guidelines for evaluation were developed to facilitate the transmission of adequate patient data, and to direct physicians as to what information is needed by the court in making guardianship decisions.
All work? A day in the life of geriatric psychiatrists
Authors: Benbow Susan M. , Jolley David J. , Leonard Ian J. 
Published: December 2004

AbstractA pilot study of old age psychiatrists' workloads was carried out using a list of old age psychiatrists compiled by the Section of Old Age Psychiatry, Royal College of Psychiatrists. Respondents gave details of their working hours and practices on one day in 1992. As a group old age psychiatrists worked long hours and continued to work after returning home, with little time for personal study and research. If confirmed in a larger study, the findings are of concern in relation to health of the workforce, and need to be considered in relation to ‘manpower’ recommendations, requirements for continuing medical education and supportive staffing, and work patterns.