bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of age on the plasma levels of amoxapine and its major metabolite in depressed patients
Authors: Aoba Anri , Yamaguchi Noboru , Tsuneizumi Tomohiro , Chishima Tatsuo , Tsuzura Michinori , Sakai Takashi , Negishi Kyoichiro , Tagaki Hiroyuki , Hasegawa Kazuo , Kitani Kenichi , Shibata Makiko 
Published: December 2004

AbstractTwenty‐eight depressed patients receiving amoxapine with ages ranging from 21 to 68 years (male 12, female 16) were studied in order to clarify the age effect on plasma levels of amoxapine and its major active metabolite, 8‐OH amoxapine. Plasma amoxapine levels were determined by both radioreceptor assay (RRA) and gas liquid chromatography (GLC). Plasma levels of 8‐OH amoxapine were also determined by GLC.A highly significant correlation was found for plasma levels of amoxapine determined by RRA and GLC (r = 0.88, p < 0.001). There was no significant correlation between the amoxapine daily dose (mg/kg) and its plasma levels determined either by RRA or GLC. The ratios of plasma amoxapine level by RRA and GLC to daily dose significantly increased with advancing age (p < 0.05) and a significant positive correlation was also found between the ratio of plasma level of 8–OH amoxapine to daily dose and the age of the patients (p < 0.01), suggesting that the plasma 8‐OH amoxapine levels were more strongly affected by age than the parent drug. These results indicate that the metabolism of amoxapine in the liver decreases with age as well as that of other tricyclic antidepressants reported previously. The higher correlation of 8‐OH amoxapine with patient's age may be mainly due to its renal excretion which may also decrease with age.
Plasma cholinesterase activities in dementias, depressions and schizophrenia
Authors: Chipperfield Barbara , Smith Timothy A. D. , Moyes Isabel C. A. 
Published: December 2004

AbstractPlasma cholinesterase activities were measured in a group of elderly patients and controls. Total cholinesterase activity was found to be decreased to a just significant extent in those suffering from endogenous depression when compared to normal controls. There was a highly significant decrease in cholinesterase activity in the plasma of patients suffering from senile dementia of Alzheimer type (SDAT) but not in those suffering from multi‐infarct dementia, neurotic depression or chronic schizophrenia. There was a just significant correlation between total cholinesterase and acetylcholinesterase activity in the plasma of patients suffering from SDAT and the degree of dementia. There were also significant differences between patients with SDAT and MID, and patients with endogenous and reactive depression. The potential use of such tests is discussed.
Sulpiride and placebo in depressed elderly outpatients: A double‐blind study
Authors: Kivelä Sirkka‐Liisa , Lehtomäki Erkki 
Published: December 2004

AbstractIn a controlled double‐blind study, sulpiride 100–200 mg daily or placebo was administered over a five‐month period to 22 and 24 depressive elderly outpatients. The majority of the patinets in both groups were diagnosed as suffering from relatively mild degrees of depression, i.e. from dysthymic disorder (chronic depression) or atypical depression. According to the Hamilton Rating Scale for Depression, the average symptomatology decreased from 19.7 to 15.7 points in the sulpiride group and from 22.8 to 17.0 points in the placebo group. The scores of three patients in the sulpiride group and those of four patients in the placebo group decreased by 50% or more. The corresponding figures for a decrease of 25–49% were six and nine, respectively. The effect of sulpiride on depressive symptoms did not differ from the effect of placebo. The results showed that sulpiride in small doses had no antidepressant effects on elderly patients suffering from relatively mild degrees of depression, i.e. from dysthymic disorder (chronic depression) or atypical depression.
Relationship between DST and the serotonergic system. Results from treatments with two 5‐HT reuptake blockers in dementia disorders
Authors: Balldin Jan , Gottries C. G. , Karlson Ingvar , Lindstedt Göran , Lérngström Göran , Svennerholm Lars 
Published: December 2004

AbstractDexamethasone suppression test (DST) were performed in patients with dementia of the Alzheimer type and multiinfarct dementia. Test–retest reliability was found to be high in dementia patients if they were inpatients and environmental factors were dept stable. In this group 14% were non‐suppressors. If outpatients were investigated, admitted to hospital for only a few days, the test–retest reliability was low. In these patient groups 39–56% were non‐suppressors.Treatment with the serotonergic (5‐HT) uptake inhibitor citalopram significantly reduced the postdexamethasone cortisol levels as well at 08.00 am as at 03.00 pm the day after intake of 1 mg dexamethasone (after 10 h and 17 h respectively). Citalopram treatment also caused significant reduction of the cerebrospinal fluid (CSF) levels of 5‐hydroxyindolacetic acid (5‐HIAA) and 3‐methoxy 4‐hydroxyphenylglycol (HMPG). A correlation was seen between the citalopram‐induced reduction of 5‐HIAA levels in CSF and the degree of dexamethasone‐induced suppression of cortisol concentrations after the treatment period. Treatment with the 5‐HT uptake inhibitor alaproclate, with a regional selectivity principally to the limbic system, had little effect on the postdexamethasone cortisol levels. The results suggest a relation between the abnormal DST in dementia and a disturbed hypothalamic 5‐HT function.
Mental disorder among nursing home patients: Preliminary findings from the national nursing home survey pretest
Authors: Burns Barbara J. , Larson David B. , Goldstrom Ingrid D. , Johnson Wayne E. , Taube Carl A. , Miller Nancy E. , Mathis Evelyn S. 
Published: December 2004

AbstractNinety‐six per cent of mentally ill elderly persons who are not in the community reside in nursing homes, yet the mental health care they receive here is minimal or unavailable. Data are presented from the 1984 pretest of the National Nursing Home Survey. Five hundred and twenty‐six patients in 112 nursing homes in four US metropolitan areas were sampled. Overall, the prevalence of mental disorder was found to be 68%; 39% of the patients had a diagnosis of organic brain syndrome (OBS) and 29% had other mental disorders (OMD). Only about one‐third (31%) of residents had no mental disorder. These three patient groups, those with OBS, those with OMD, and those with no mental disorder, were compared on demographic, clinical, and treatment characteristics. The authors conclude that the balance between the Federal and State roles in financing care for the mentally ill in nursing homes needs to result in a more equitable system of care which does not discriminate against the mentally ill. Further, the mental health service system needs to assume greater responsibility for this population. While signnificant attention is given to residents' physical needs, behavioural and emotional problems are seriously neglected.
Selective loss of serotonin recognition sites in the parietal cortex in Alzheimer's disease
Authors: Procter Andrew W. , Middlemiss Derek N. , Bowen David M. 
Published: December 2004

AbstractNumbers of serotonin (5‐HT) recognition sites of total 5‐HT1, 5‐HT1A and 5‐HT2 subtypes have been measured in frontal, temporal and parietal cortex from human brain postmortem, using binding of [3H] 5‐hydroxytryptamine (5‐HT), [3H] 8‐hydroxy‐2‐(di‐n‐propylamino) tetralin and [3H] ketanserin, respectively. A comparison has been made between 11 patients with Alzheimer's disease (AD) and 20 matched controls. Significant disease‐related differences were observed only in the parietal cortex for total 5‐HT1 and 5‐HT2 recognition sites. Age‐related decrease in numbers of 5‐HT2 recognition sites was seen in the controls, whereas an age‐related increase in the numbers of the same site was seen in AD patients. These changes are discussed in relation to disease severity and cortical nerve cell loss in ageing and AD.
Neuroleptics in the treatment of dementia
Authors: Sunderland Trey , Silver Michael A. 
Published: December 2004

AbstractThe authors review the history of neuroleptic treatment in dementia. The initial review of 34 studies published since 1954 was limited to the 20 double‐blind and / or placebo‐controlled studies. Sixty per cent of the studies revealed generally positive clinical results in demented patients following neuroleptic treatment. Acute side‐effects were not reported to be more prevalent or severe than in other psychiatric populations and included sedation, orthostatic hypotension, extrapyramidal reactions, and various anticholinergic symptoms. Careful assessment of the cognitive effects following neuroleptics, particularly those with known anticholinergic properties, was not performed in most of these studies and should be a focus of future prospective studies in this population. Nonetheless, it does appear that neuroleptics have a role in the treatment of patients with dementia. When used at low doses for specific purposes (i.e. treatment of agitation, hyperactivity, hallucinations, or hostility), they can both safe and effective in this population.
Impact of team approach on reducing drug costs
Authors: Karki Shyam D. , Chandra Pradeep , Holden J. M. C. , Shehata Hany 
Published: December 2004

AbstractAfter partial success of traditional methods (closed formulary, use of generic drugs, retrospective drug usage review and continuing education) to reduce drug costs, a new‐approach ‘team approach’ was tried. This involved a clinical pharmacist and psychiatrists jointly reviewing patient drug therapies in view of a previously agreed set of guidelines. These guidelines were formulated to optimize patient therapy after a thorough review of clinical pharmacology and pharmacokinetics of drugs and pathophysiology of different psychiatric disorders. Drug cost savings of 49% and 16% were achieved in two different wards. The clinical pharmacist's active involvement accounted for a difference of 33% between the two wards.
Calcium antagonists and multi‐infarct dementia: A trial involving sequential NMR and psychometric assessment
Authors: Besson J. A. O. , Palin A. N. , Ebmeier K. P. , Eagles J. M. , Smith F. W. 
Published: December 2004

AbstractA double‐blind placebo‐controlled trial of the calcium antagonist Nimodipine in 10 patients with multi‐infarct dementia (MID) shows that there is no improvement when compared with 10 patients on placebo assessed by clinical ratings and sequential NMR imaging. The value of repeated NMR imaging in measuring changes in MID is described.
Referrals to a psychogeriatic consultation–liaison service
Authors: Scott Jan , Fairbairn Andrew , Woodhouse Ken 
Published: December 2004

AbstractThis study reviews referrals of elderly medically ill patients to a psychogeriatric team in a district general hospital. Sociodemographic variables, medical diagnosis, source and reasons for referral, and primary DSM III diagnosis were determined. The impact on referral patterns of the introduction of a pscychogeriatric liaison attachment to complement the existing consultation service was also assessed.In three years, 217 patients were referred, the majority from the general medical specialities. The median age of the sample was 79.5 years, more than half were female and over 60% demonstrated multiple physical pathology, particularly cerebrovascular and cardiovascular disorders. The most prevalent psychiatric diagnoses were dementia, delirium and depression. The pattern of referrals changed significantly with the introduction of the consultation–liaison service. The number of referrals increased by over 100% and there was a significant increase in the recognition and referral of functional psychiatric disorders, especially depression. The role of the geriatricians and the liaison psychiatry attachment in promoting these changes and the clinical, teaching and research advantages of this type of collaboration are discussed.
Psychiatric assessment in medical long‐term care facilities: Reliability of commonly used rating scales
Authors: Foster Jeffrey R. , Sclan Steven , Welkowitz Joan , Boksay Istvan , Seeland Irene 
Published: December 2004

AbstractClinical assessment of psychopathology includes quantifying symptoms on rating scales. Caution must be used in applying standardized instruments to new populations because their reliability may alter considerably. This study assesses the interrater reliability of six well‐known rating scales when applied to patients residing in a medical long‐term care facility. The scales include measures of depression, psychosis and cognitive impairment. The specific scales used were: Hamilton Depression Scale; Brief Psychiatric Rating Scale; Mini‐Mental State Examination; Mental Status Questionnaire; Global Deterioration Scale; and Brief Cognitive Rating Scale.
Risk factors for dementia: Evidence from the liverpool study of continuing health in the community
Authors: Dewey Michael E. , Davidson Ian A. , Copeland John R. M. 
Published: December 2004

AbstractOne thousand and seventy residents in the community in Liverpool aged 65 and over were interviewed using the GMS–AGECAT package. Various suggested risk factors for Alzheimer's disease were examined. Our results are in line with the conclusions drawn from earlier case‐control studies: most of the factors are not associated with a change in risk. An important new result was the finding that a history of headache or dizziness led to a reduced risk of subsequent dementia. This finding is consistent with that of Heyman et al. (1984), although it was not statistically significant in their smaller study.
Changes in P‐300 latency as a result of co‐dergocrine mesylate therapy in patients with senile dementia
Authors: Breeze R. W. , Cox Sheila , Rodgers‐Cox J. 
Published: December 2004

AbstractMost studies of the effects of drugs in senile dementia have used subjective rating scales to measure change in mental and cognitive function. Few have used objective measurement. The purpose of this study was to compare the latency of the P‐300 component of the event‐related auditory evoked potential before and after drug treatment. Twenty‐one patients aged 74–93 with dementia defined by a score of>10 and <25 using the Mini‐Mental Status Test of Folstein were treated with Hydergine 13.5 mg or placebo under double‐blind randomized conditions for a period of six weeks. The mean P‐300 latency in the active group showed a decrease of 60 ms whilst that of the placebo group was prolonged by 25 ms. The difference was statistically significant (p<0.5) in favour of the active drug. These data suggest that this method of assessment is sensitive to drug‐induced changes in patients with senile dementia.
The blessed dementia scale as a screening test for dementia
Authors: Erkinjuntti T. , Hokkanen L. , Sulkava R. , Palo J. 
Published: December 2004

AbstractThe Blessed Dementia Scale (DS) is a brief behavioural scale based on the interview of a close informant. Its validity as a screening test was evaluated in 105 demented patients and 123 community residents. The DS proved to be a sensitive and specific screening test for dementia, especially when items related to personality changes were omitted by constructing a revised DS (RDS). Both the DS and RDS correlated with the patients' neuropsychological test performance. They also differentiated patients with different degrees of dementia. In the screening of dementia the cut‐off point of 4 in the DS gave a sensitivity of 90% and a specificity of 84%. In the RDS the cut‐off point of 1.5 gave a sensitivity of 93% and a specificity of 97%. Behavioural rating scales such as the DS are valuable in the screening of dementia, especially when combined with cognitive testing. In addition they can be used in the evaluation of the degree of disability and in the planning of social support.
State of health and social situation of elderly persons living in a large city
Authors: Bergener M. , Husser J. , Kranzhoff E. U. 
Published: December 2004

AbstractData on state of health and social situation were collected from two samples of elderly people livinig in Cologne, a sample living in the community in their own homes and a sample living in institutions. There was a high prevalence of physical disorder, especially in those in residential care, and an overall prevalence of organic cerebral disorder of 5.5%. Some methodological problems of using physicians to carry out the survey rather than trained lay interviewers are presented.
Dementia, depression and subsequent institutionalization—the effect of home support
Authors: Lindsey James , Murphy Elaine 
Published: December 2004

AbstractThe Guy's/Age Concern Home Support Project is a prospective controlled intervention study of the effect of client‐centred home support for elderly people with dementia. Control subjects who were in institutions at six months follow‐up were significantly more depressed and physically disabled at referral than those who remained at home. Among those receiving additional home support, however, there was no difference between the depression and disability scores at referral of those who were institutionalized and those who remained at home at follow‐up. These results suggest that the high prevalence of depression and physical disability in the institutionalized elderly is due to preferential selection into institutions, and that this process is prevented by providing this form of domiciliary support.
The prevalence of depression in an acute geriatric medical assessment unit
Authors: O'Riordan Thomas G. , Hayes James P. , Shelley Rory , O'Neill Desmond , Walsh J. Bernard , Coakley Davis 
Published: December 2004

AbstractOne hundred and eleven patients admitted to an acute medical geriatric assessment unit were screened for depression using the Geriatric Depression Scale questionnaire. All patients with high scores were further assessed by a consultant psychiatrist in a semistructured interview. Of the patients screened, 23.4% had depression of a clinically significant degree and 13.5% were judged to need specific antidepressant medication. 10.8% of the population had depressive illness superimposed on organic brain disease.
A comparison of ‘specialized’ and ‘non‐specialized’ psychiatric services for old people in the united kingdom
Authors: Wattis John Philip 
Published: December 2004

AbstractUsing data derived from a recent survey of psychiatric services for old people in the UK, services provided by ‘specialized’ consultants (committing 5/11 or more of their working week to old people) were compared with those provided by ‘non‐specialized’ consultants (working less than 5/11 with old people). The measures used included total referrals, provision of personnel, provision and location of facilities, teaching activities and research interests. Because of the way in which they were selected, non‐specialized respondents were a relatively small and probably enthusiastic proportion of all non‐specialized general psychiatrists providing services for old people. Despite this, clear differences emerged in favour of the specialized services on most measures. Future routine statistics in psychiatry should identify ‘specialized’ consultants if they are to be meaningful.
Age, manic psychopathology and treatment response
Authors: Young Robert C. , Falk James R. 
Published: December 2004

AbstractThe authors describe relationships between age and ratings of signs and symptoms in 40 manic inpatients. Soon after admission, some psychopathologic features were less prominent in older patients. In older patients, after two weeks of treatment with lithium and neuroleptics, there was greater residual total psychopathology, higher ratings of some clinical features, and less change in total psychopathology and some clinical features. Older patients were hospitalized longer. Ageing may alter manic psychopathology and treatment response. The authors emphasize the need for prospective studies that include geriatric patients.
The effect of design of residential homes in creating dependency among confused elderly residents: A study of elderly demented residents and their ability to find their way around homes for the elderly
Authors: Netten Ann 
Published: December 2004

AbstractA study of 13 homes for elderly people examining the effect of the environment on demented residents looked into the complexity of the design from the residents' point of view. Two principal tools were used in this investigation: ‘route diagrams’, which describe a resident's use of the home, and a measure devised to indicate each resident's ability to find her way around the home. These are described and the relationship between them explored. From this the following tentative conclusions are drawn:

The variables that influence a resident's ability to find her way around differ between group and communally designed homes.
It would appear that group homes provide a more favourable design, especially in the case of physically frail demented elderly people.
In group homes, the level of lighting is an important aid to a demented person in finding her way around.
In communal homes, residents seem most able to find their way around homes that have been adapted from older premises.
In both types of home, ‘meaningful decision points’ can be seen as aids to a resident finding her way around.
Integrity‐promoting care of demented nursing home patients: Psychological and biochemical changes
Authors: Bråne Görel , Karlsson Ingvar , Kihlgren Mona , Norberg Astrid 
Published: December 2004

AbstractThe effects of integrity‐promoting care in a nursing home with demented patients were studied. In one ward the staff were given special training. The results showed that the treatment induced a reduction of distractability, confusion, anxiety and depressed mood, and improvement in motor performance. At the same time the cerebrospinal fluid concentrations of somatostatin increased.
Social work and people with dementia: Putting principles into practice
Authors: Polden Esther Rachel 
Published: December 2004

AbstractThe Kantian principle of ‘respect for persons’ has traditionally held a central place in social work theory and practice. It is argued here, however, that the language of ‘respect for persons’ falls short of giving a full account of the complex nature of social work intervention in relation to elderly persons who have dementia, and so ultimately of having practical application. An alternative framework based on the theory of consent is proposed. The aim is to put into practice the principle that all persons have the right to make decisions about their own lives no matter how disabled they may be. This involves assessing the competence of individuals to give informed consent. There is also the need to offer alternative strategies to assist persons who, because of the severity of their dementia, are not deemed competent to make a particular decision. Three options are considered: justified paternalism, consent by proxy and ‘citizen advocacy’. But a fourth option is preferred in what Paul Ramsey, in his book The Patient as Person: Explorations in Medical Ethics (see Faulder, 1985), has termed ‘constructive consent’, where the decision to give consent is based on the knowledge that the individual concerned would certainly have consented if competent to do so. In this way, the language of consent gives shape and content to Immanuel Kant's formulation of ‘respect for persons’, providing a theoretical and practical framework which promotes morally and professionally proper practice.