bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depressive symptoms in the very elderly—their prevalence and significance
Authors: Girling Deborah M. , Huppert Felicia A. , Brayne Carol , Paykel Eugene S. , Gill Caroline , Mathewson Diane 
Published: December 2004

AbstractA community sample of 1173 very elderly people (aged over 77) was interviewed by trained lay interviewers using a structured interview, including questions relating to emotional and physical health and social circumstances and the Mini‐Mental State Examination. Depressive symptoms such as loss of energy and feelings of tension and irritability were found frequently. High scores for depressive symptoms were associated with female sex, poor subjective physical health, loneliness and use of statutory services. Depressive symptom score was not found to be associated with age. Although only 6% of the sample described feeling depressed most of the time, 21% of respondents admitted that they sometimes felt that life was not worth living.
Autopsy diagnoses of Alzheimer disease: Independent reviews and clinical implications
Authors: Jarvik Lissy F. , Matsuyama Steven S. , Chui Helena , Scheibel Arnold B. , Vinters Harry V. 
Published: December 2004

AbstractAt present, the neuropathologic examination is universally regarded as essential for the final diagnosis of Alzheimer disease (AD). However, there is absence of agreement on what areas to examine, what stains to use, which lesions to report, and how to interpret other neuropathologic findings. In this study, we describe the results of reviewing the neuropathologic findings in probands from a family study of AD who had received a clinical diagnosis of ‘probable AD’ (N = 33). A neuropathologic diagnosis of AD was received for 88% of the probands, a proportion entirely in agreement with that reported in the literature. An independent review of the autopsy reports found variability in whether the neuropathologic diagnosis was based on the presence of plaques or tangles or both. Further, when a subset of histologic slides was reviewed by two researchers working in the field of AD, there were substantial diagnostic discrepancies. These findings indicate the need for standardized protocols, but suggest that even they have limitations. These limitations are of particular concern when estimating vulnerability to AD of first‐degree relatives. Thus, while neuropathologic examination continues to provide invaluable information about the causes of dementia, it cannot be regarded as a gold standard for diagnosis of individual cases.
Needs assessment in old age psychiatry—a need for standardization
Authors: Hamid Walid Abdul , Howard Robert , Silverman Marisa 
Published: December 2004

AbstractNeed assessment is an important component in planning, prioritizing and evaluating care provision. Old age psychiatry is an expanding community‐based speciality. It is important for community mental health services to be need‐led (McCrone and Strathdee, 1994), since this ensures better targeting of the limited resources. The available needs assessment instruments are either those problem‐oriented methods that have limited applicability in health service planning or methods that are too complicated and cumbersome to be used in the community. Some of these instruments have been standardized on adult general psychiatry patients and might not be appropriate for old age psychiatry services. There is thus an opportunity for the development of a needs assessment method that is standardized on old age psychiatry patients and measures need for the range of interventions offered by old age psychiatry services.
Anxiety and quality of life in residents of a special nursing home
Authors: Nagatomo Itsugi , Nomaguchi Mitsuo , Takigawa Morikuni 
Published: December 2004

AbstractForty residents of a special nursing home in Japan were categorized as low or high anxiety according to the State–Trait Anxiety Inventory. Using a Japanese version of the Self‐Rating Depression Scale by Zung (SDS) and the Quality of Life (QOL) rating scale designed by Iida et al. (QOL scale), we compared the QOL and depressive states of the two groups. Although scores in all categories of the modified Stockton Geriatric Rating Scale (a behavioural rating scale) of the two groups, as rated by a skilled nursing staff, did not differ significantly, scores in all categories of the QOL scale and the SDS were significantly higher in the group with high anxiety. Such higher scores indicated a greater impairment. Our results suggest that the QOL in residents with high anxiety was lower than in those with low anxiety, and the QOL of residents of special nursing homes could not be measured by a behavioural rating scale.
Nurses' job satisfaction and the quality of care received by patients in psychogeriatric wards
Authors: Robertson Alex , Gilloran Alan , McGlew Tom , McKee Kevin , McKinley Andrew , Wight Daniel 
Published: December 2004

AbstractThe methodology and part of the results of an in‐depth observational study of four psychogeriatric hospitals are described, focusing on the quality of care received by patients and how this was affected by the level of job satisfaction among nurses. In all four hospitals two wards were selected for intensive study over a period of 4–5 months each. Quality of care was studied through standardized recording of staff's feeding, toileting and bathing of a stratified sample of patients. The findings point to a very strong relationship between job satisfaction and quality of patient care. Staff and patients in high‐satisfaction (HS) wards proved more likely to initiate a conversation or other interaction. HS staff also offered patients more choice, independence, personal attention, supervision, information and privacy, and were more likely to converse with patients during feeding, toileting and bathing. Toileting and bathing appeared especially sensitive to these effects. Despite these differences, HS staff took no longer to feed, toilet or bathe their patients. These relationships are suggested to be mainly attributable to management practices, particularly at ward level, which influence both job satisfaction and quality of patient care.
Glucose metabolic rate and progression of illness in Alzheimer's disease
Authors: Siegel Benjamin V. , Buchsbaum Monte S. , Starr Arnold , Mohs Richard C. , Neto Dirceu C. 
Published: December 2004

AbstractThirty‐eight patients with mild to moderate Alzheimer's disease (AD) underwent a neuropsychological test battery and 18‐fluoro‐2‐deoxyglucose (FDG) positron emission tomography (PET) before beginning and at the end of a randomized double‐blind study of an experimental treatment. Twelve of the patients took placebo. In the placebo patients, Mini‐Mental State (MMS) score decreased and cortical metabolism increased significantly over the 6‐month course of the study. Correlations of metabolism with neuropsychological performance were stable over time in the placebo group. Cortical metabolism correlated significantly with performance on the Blessed Information Subtest and the MMS and showed trend correlations with performance on the WAIS Digit Symbol and Word Fluency. Patients with high relative occipital metabolism tended to do poorly on word fluency. Low baseline relative metabolism in right frontal cortex and high baseline relative metabolism in left parietal and temporal cortices and in right occipital cortex predicted more 6‐month deterioration on the World Fluency Test, suggesting that frontal metabolic deficits may precede neuropsychological deficits. Correlations of 6‐month change in MMS, Blessed and Digit Symbol performance with initial glucose metabolism were not significant.
Discriminating power of the hachinski ischaemic score in a geriatric population with mild dementia
Authors: Swanwick Gregory R. J. , Coen Robert F. , Lawlor Brian A. , O'Mahony Denis , Walsh J. Bernard , Coakley Davis 
Published: December 2004

AbstractThe Hachinski Ischaemic Score (HIS) is used to clinically discriminate multi‐infarct dementia (MID) and primary degenerative dementia (PDD). The present study aims to evaluate the discriminating power of the individual HIS items in a geriatric population with mild dementia. The 13 HIS items were studied in 93 demented subjects with no evidence of infarction, a single cortical infarct or multiple cortical infarcts on CT brain scan. The item ‘hypertension’ was a poor discriminator between PDD and MID in this elderly population; however, the remaining unambiguous items ‘abrupt onset’, ‘neurological sings’, ‘neurological symptoms’, ‘history of stroke’ and ‘atherosclerosis’ were useful discriminators. We found that five of the least discriminating items diverged from the aspects of MID that they were originally intended to address and were, therefore, particularly ambiguous. In order to improve the discriminating power of these items and the HIS as a whole, we recommend dividing the 13 items into four categories, ‘evidence of delirium’, ‘evidence of focal deficits’, ‘evidence of vascular pathology’ and ‘abrupt onset’, to minimize any problems with interpretation of the more ambiguous items.
A comparison of clock and pentagon drawing in Alzheimer's disease
Authors: Bourke John , Castleden C. Mark , Stephen Ronnie , Dennis Michael 
Published: December 2004

AbstractClock drawing is described as a novel, easily administered bedside measure of cognitive function. We examined from 77 ambulant elderly persons meeting NINCDS criteria for Alzheimer's disease their drawings of clock faces and overlapping pentagons. Interrater reliability for two previously published scoring scales for clocks and a devised ordinal scale for overlapping pentagons was high. There was moderate correlation with their total scores on the CAMCOG and Mini Mental State Exam (MMSE). However, a considerable number of patients scored within the normal range on all three drawing scales. A third (23/77) on clock drawing demonstrated their only abnormality at setting the time to 10 to 11 instead of the requested 10 past 11. For the clock drawing test to be used as a rapid screening instrument for Alzheimer's disease in the community an accurately drawn clock face must include the correct position of the hands. The pentagon test either alone or in combination did not enhance the accuracy of the clock test.
Abuse of patients with dementia by carers — out of sight but not out of mind
Authors: Cooney Colm , Howard Robert 
Published: December 2004

AbstractElderly people with dementia living with a carer are at significantly higher risk of abuse than the general population over 65. This review looks at the limitations of the research to date and discusses risk factors in both carers and patients that predispose them to abuse. Management strategies are discussed with reference to the growing research base.
Giving up driving in Alzheimer's disease—an integrative therapeutic approach
Authors: Bahro Marcel , Silber Earle , Box Paulette , Sunderland Trey 
Published: December 2004

AbstractFor patients with Alzheimer's disease (AD), a recommendation to stop operating a motor vehicle can be a serious event complicated by a loss of self‐esteem and personal dignity. Patients are often reluctant to give up an activity so essential, both practically and symbolically, to independent living. We describe here a patient with moderately progressed AD who lacked insight of his need to cease driving. Through an integrative treatment approach, combining behavioral and psychodynamic modalities, we helped him to formulate effective ways of coping with his loss of access to independent transportation. We favor a psychotherapeutic strategy that combines behavioral and managerial measures with dynamic patient interaction, thereby developing the patient's insight of the need to give up driving while fostering his sense of autonomy.
Dementia known to mental health services: First findings of a case register for a defined elderly population
Authors: Holmes Clive , Cooper Brian , Levy Raymond 
Published: December 2004

AbstractThe aims and methodology of the population‐based Camberwell Dementia Case Register are described. Data collected during the first 18 months of the Register's operation have been used to check the reliability of clinical diagnosis as assessed on the one hand by standardized interview and test procedures and on the other hand from available hospital records; further, to examine the predictive validity of a ‘consensus’ diagnosis by comparison with the neuropathological findings in deceased patients. A diagnostic breakdown of 510 cases screened during this initial period is presented, and both point prevalence ratios and one‐year incidence rates for ‘declared’ cases of dementia in the Camberwell elderly population computed. Analysis of the current living situation and care status on a census day (31.10.94) revealed that 10% of the patients were occupying NHS beds, 45% in long‐stay residential care and the remaining 45% still living in private households, with varying degrees of support.
Violence among psychogeriatric inpatients with dementia
Authors: Shah Ajit 
Published: December 2004

AbstractThe characteristics of all patients with dementia admitted to an acute psychogeriatric admission ward over a 36‐month period were examined. Patients with dementia who had been responsible for acts of violence were compared with those with dementia who had not. Violent patients were more likely to have an ICD‐9 diagnosis of senile dementia. Levels of violence were low, with only a small number of patients exhibiting violent behaviour. The implications of these findings for evaluative studies of pharmacotherapy and staff training in aggression control techniques are discussed.
Are professional footballers at risk of developing dementia?
Authors: Spear Jon 
Published: December 2004

AbstractFootball is a contact sport which involves heading the ball and clash of heads, both having the potential for causing repetitive minor head injury. Much of the research on the association between football and Alzheimer's disease (AD) is flawed, but what is available suggests that footballers are more likely to have EEG abnormalities, cortical atrophy and mild neurological abnormalities than controls. It is also known that head injury may precipitate a cascade of events leading to AD pathology by increasing the expression of amyloid precursor protein and increasing amyloid deposition. It is not known if footballers have an increased risk of dementia, but it is possible that they do. Preventative action could be taken by football's governing bodies to reduce the risk of brain damage as a result of head injury and subsequent development of dementia.
Evaluating the usefulness of training in psychogeriatrics
Authors: Saarela Tuula , Kiviharju Upu 
Published: December 2004

AbstractA training programme in psychogeriatrics was run for 51 primary health care doctors, nurses and social workers split into two groups for training in two formats. One group was a patient‐case group and the other a lecture group. The participants were interviewed 2–4 months after the course and the material analysed by the phenomenographic method. The main result of the training for both groups, from the trainees' point of view, was an enhanced experience of psychogeriatric work and a more creative application of preexisting professional knowledge. No differences in outcome were detected between the groups. Problems in achieving effective training and training evaluation are discussed.
The quality of long‐term care for dementia: A survey of ward environments
Authors: Mountain Gail , Bowie Peter 
Published: December 2004

AbstractA survey of long‐stay wards for elderly demented patients was carried out. The quality of five aspects of ward environment was assessed, covering institutional practices, social/recreational input, reality orientation cues, ward condition and space availability. Of the 28 wards surveyed, two‐thirds achieved high quality on one aspect but only two wards had high quality on three or more aspects. In contrast, 14% of the wards obtained low‐quality scores on at least three aspects. A hospital trend was found for the variation in institutional care practices. The results have implications for staff training and for reprovision programmes.
How can we detect sick elderly excessive drinkers?
Authors: Naik P. C. , Jones R. G. , Lilley J. 
Published: December 2004

AbstractThe sensitivities and specificities of alcohol history, alcohol history with a specific additional question, ‘Do you drink spirits in your tea or coffee, or both’, alcohol questionnaires (SMAST and CAGE) and laboratory investigations (γGT and MCV) as indicators of excessive alcohol intake among elderly (≥ 65 years) acute medical admissions were studied and compared. Alcohol history with the specific additional question was the most sensitive indicator. Initial alcohol history had a sensitivity of 50%. Both alcohol questionnaires had a sensitivity of 0% and it is recommended that new questionnaires specifically for use in the elderly should be developed and validated. γGT was 50% sensitive with a specificity of 80%. MCV had a sensitivity of 17%. Both MCV and γGT should be used with caution as indicators in this age group. A simple alcohol history with the additional specific question is at present the best indicator of excessive alcohol intake.
End‐stae dementia in adults with down syndrome
Authors: Prasher V. 
Published: December 2004

AbstractEnd‐stage dementia in adults with Down syndrome has not been fully investigated. Available information, 6 months prior to death, for 20 adults with Down syndrome who had died with Alzheimer's disease was reviewed. A terminal stage of severe intellectual deterioration, marked personality and mood changes, loss of sphincter control, seizure activity, immobility with hypertonia and complete loss of self‐care skills was found. These findings have important clinical and service implications.
Imaging the spatiotemporal dynamics of cognition with high‐resolution evoked potential methods
Authors: Gevins Alan , Cutillo Brian , Durousseau Don , Le Jian , Leong Harrison , Martin Nancy , Smith Michael E. , Bressler Steven , Brickett Paul , McLaughlin Judith , Barbero Nicholas , Laxer Kenneth 
Published: December 2004

AbstractSubsecond temporal resolution is necessary to resolve the changes in brain activity that are associated with task‐related cognitive processes. Evoked potentials (EPs) provide the requisite millisecondrange temporal resolution, and do so with nonencumbering recordings at a reasonably low cost. These features would seem to make EPs the ideal complement to structural and functiona magnetic resonance images (MRIs) and positron emission tomography (PET). However, until recently, the utility of EPs has been limited by their poor spatial resolution. Sufficient spatial correspondence has not existed between EPs and other brain imaging modalities to determine unambiguously the relationship between a sequence of EP components and structures visualized by MRI or PET. We describe progress that has been made toward overcoming this obstacle by registering electrophysiological data with anatomical information from each subject's MRI, by improving the spatial resolution of the EP, and by using analytic methods for measuring the spatiotemporal dynamics of distributed neurocognitive processes. The use of these techniques is illustrated by reviewing several experiments in which sequences of component neural processes were measured during cognitive tasks. © 1994 Wiley‐Liss, Inc.
Spatiotemporal analysis of brain electrical fields
Authors: Tucker Don M. , Liotti Mario , Potts Geoffrey F. , Russell Gerald S. , Posner Michael I. 
Published: December 2004

AbstractPsychological studies with reaction time methodology show that there is meaningful variability in the performance of cognitive operations when responses are measured in milliseconds. Temporal precision is also required to reveal the rapid neurophysiological events in cortical networks. Sampling the brain's electrical activity at the scalp surface characterizes regional brain function with millisecond temporal resolution. The problem with electroencephalographic (EEG) data is localizing the areas of the cortex that generate the observed scalp fields. Although the eventual goal will be to specify the neural generators of the EEG, we propose that an important first step for functional studies is to examine accurate, time‐dynamic maps of the brain's electrical fields at the head surface. Given an adequate spatial sampling of the surface potentials, accurate electrical studies require measures that are independent of the location of the reference sensor. The 2D Laplacian of the potential field may be used to define the local features of the scalp current flow. Because the electrical fields are dynamic, brain mapping with electrical data requires animations rather than static images. © 1994 Wiley‐Liss, Inc.
Micromapping of the human brain: Three‐dimensional imaging of immunofluorescence and dendritic morphology using dual‐channel confocal laser scanning microscopy
Authors: Belichenko Pavel V. , Dahlström Annica B. 
Published: December 2004

AbstractA strategy for investigating neuronal networks at the microscopic level is described. The Lucifer Yellow microinjection technique was combined with immunofluorescence on human brain material, which was then studied in a confocal laser scanning microscope with dual‐channel scanning and equipped with an argon/krypton laser. The three‐dimensional architecture of the Lucifer Yellow‐injected neurons was investigated after transfer of the scanned frames in file format to a Silicon Graphics IRIS computer, using VoxelView software from Vital Images Inc. Microinjection of Lucifer Yellow revealed the dendritic morphology of various types of cells in different brain areas. Indirect immunofluorescence, with Texas Red as the secondary label, was used to determine the distribution of various categories of macromolecules (enzymes, receptor protein, and synaptic vesicle proteins) in the brain slices. We used single‐ as well as dual‐channel confocal laser scanning microscopy for imaging these double‐stained fluorescent specimens. Using these techniques in combination, we have created and saved three‐dimensional confocal images of detailed morphology (axons and dendrites with spines and varicosities) of individual cells, together with the localization of immunofluorescence. These three‐dimensional confocal images will be collected in a database for probable future use in human brain mapping. © 1994 Wiley‐Liss, Inc.
Assessing the significance of focal activations using their spatial extent
Authors: Friston K. J. , Worsley K. J. , Frackowiak R. S. J. , Mazziotta J. C. , Evans A. C. 
Published: December 2004

AbstractCurrent approaches to detecting significantly activated regions of cerebral tissue use statistical parametric maps, which are thresholded to render the probability of one or more activated regions of one voxel, or larger, suitably small (e. g., 0.05). We present an approximate analysis giving the probability that one or more activated regions of a specified volume, or larger, could have occurred by chance. These results mean that detecting significant activations no longer depends on a fixed (and high) threshold, but can be effected at any (lower) threshold, in terms of the spatial extent of the activated region. The substantial improvement in sensitivity that ensues is illustrated using a power analysis and a simulated phantom activation study. © 1994 Wiley‐Liss, Inc.