bluuebunny/crossref_metadata_2025_split huggingface dataset:
A psychogeriatric community outreach service: Description and evaluation
Authors: Seidel G. , Smith C. , Hafner R. J. , Holme G. 
Published: December 2004

AbstractThe structure and function of a small psychogeriatric community outreach team is outlined, together with the results of intervention in 100 consecutive cases. Patients in residential or nursing home care were rated for level of behavioural disturbance at entry to the study and after three months. Patients with dementia and psychotic disorders showed clinically and statistically significant improvement, whereas the improvement of patients with major depression was not statistically significant. The usefulness of the outreach service was evaluated independently by carers and by referring agents. Eighty per cent of carers and 87% of referring agents rated the service as useful or very useful. It was concluded that a small outreach team (comprising the equivalent of only six full‐time staff) is an effective and acceptable supplement to the overall care of psychogeriatric patients.
Affective behaviour and success of EMI community home placement
Authors: Wood Kenneth A. , Cooper Jean , Richardson Kim , Forbes Alasdair 
Published: December 2004

AbstractCognitively impaired or mentally ill older individuals placed in community accommodation specifically for the elderly mentally infirm (EMI) may not always be viewed as successfully placed by residence staff. This sometimes necessitates a move to alternative care. This article examines several factors that may influence care staff views about current success of residents' placement and finds that affective behavioural factors correlate more strongly with this than either cognitive function as measured by Mini Mental State or behaviour reflected in Crichton Rating Scale scores.
Prescribing residential respite care for dementia—effects, side‐effects, indications and dosage
Authors: Brodaty Henry , Gresham Meredith 
Published: December 2004

AbstractRecent momentum for increased provision of residential respite services for people with dementia is not supported by empirical data. Yet the literature is replete with anecdotal reports indicating the efficacy of residential respite. This discrepancy may have resulted from methodological flaws in the research, lack of awareness by consumers and health professionals and great diversity in the reasons for, and among the recipients of, respite. The prescription of respite care will need to be more specific and rigorous—matching the correct dose of respite care to the needs of recipients and caregivers—for future research to demonstrate its efficacy.
Zuclopenthixol and thioridazine in the treatment of aggressive, elderly patients: A double‐blind, controlled, multicentre study
Authors: Harenko A. , Alanen I. , Elovaara S. , Ginström S. , Hagert U. , Savijärvi M. , Yli‐kerttula A. , Elgen K. 
Published: December 2004

AbstractA four‐week double‐blind study of zuclopenthixol and thioridazine in 64 elderly patients presenting with hostility or restlessness has been carried out in five Finnish mental hospitals. The ages of the patients in the two groups ranged from 64 to 97 years. The initial daily dose was 2–6 mg zuclopenthixol or 20–60 mg thioridazine. In week 4 the mean daily dose was 6.8 mg zuclopenthixol and 62 mg thioridazine. AFter one week of treatment the severity of illness was reduced significantly in the zuclopenthixol group and in both groups after two and four weeks. The key symptom hostility showed significant improvement in both treatment groups after only one week of treatment. The other key symptom restlessness was also significantly improved in both groups. The only significant difference between the groups was a better effect on sleep disturbance with zuclopenthixol. Few side‐effects were recorded in either group, and no serious effects on cardiovascular function were found. The study indicates that both zuclopenthixol and thioridazine are effective drugs in the treatment of elderly patients with symptoms such as hostility, aggressiveness and restlessness.
Concepts of mild memory impairment in the elderly and their relationship to dementia—a review
Authors: Dawe Bridget , Procter Andrew , Philpot Michael 
Published: December 2004

AbstractThe concept enshrined by Kral (1962) in the term ‘benign senescent forgetfulness’ is reviewed together with a number of other diagnostic terms synonymous with mild memory impairment. Data from epidemiological studies which employ them are presented and the relationship between ‘normal’ ageing, subjective memory complaints and dementia is discussed. Mild memory impairment in late life is associated with an increased risk of developing dementia but it is difficult from present studies to quantify this.
Do subjective memory complaints precede dementia? A three‐year follow‐up of patients with supposed ‘benign senescent forgetfulness’
Authors: O'Brien John T. , Beats Barbara , Hill Katie , Howard Robert , Sahakian Barbara , Levy Raymond 
Published: December 2004

AbstractA three‐year follow‐up study is reported of people presenting to a hospital memory clinic with ‘benign senescent forgetfulness’.All were complaining of forgetfulness for which no organic or psychiatric cause could be found. Sixty‐four out of the 68 patients initially seen were traced, of whom three had died. Six (8.8%) were found to have become demented, a slightly higher proportion than would be expected given the age of the population. No particular clinical features were found that predicted the subsequent development of dementia. Cognitive performance of remaining non‐demented subjects showed a significant but relatively modest decline, probably related to the effects of normal ageing. It is concluded that memory complaint must be taken seriously in the elderly and may sometimes indicate early dementia despite normal scores on simple screening tests. However, a finding of normality after careful assessment is reassuringly correct in the majority of cases.
Reliability and validity of the Cohen–Mansfield agitation inventory in institutionalized elderly
Authors: Finkel Sanford I. , Lyons John S. , Anderson Rachel L. 
Published: December 2004

AbstractThe reliability and validity of the Cohen–Mansfield Agitation Inventory (CMAI) were studied in residents of a long‐term care facility. The CMAI demonstrated high internal consistency, but only marginally adequate interrater reliability. Correlations with the Behavioral Syndromes Scale for Dementia (BSSD) and the Behavioral Pathology in Alzheimer's Disease (Behave—AD) provide support for the contention that the CMAI is valid measure of agitation with nursing home residents.
Psychiatric disorders among elderly patients attending a geriatric medical day hospital: Prevalence according to clinical diagnosis (DSM‐III‐R) and agecat
Authors: Turrina Cesare , Siciliani Orazio , Dewey Mike E. , Fazzari Giuseppe C. , Copeland John R. M. 
Published: December 2004

AbstractOne hundred and fourteen elderly medically ill day patients were interviewed in order to assess the prevalance of DSM‐III‐R main psychiatric disorders. Dementia affected 14.0% of the subjects, major depression 20.3%, dysthymic disorder 4.4%, atypical depression 13.2%, other disorders 3.6%. Overall, 60.5% of the patients had a psychiatric disorder. The computerized case designation (AGECAT) showed an acceptable concordance with clinical diagnoses (kappa value for dementia 0.59, for depression 0.58). Some issues related to the high prevalence of major depression are discussed.
Psychiatric morbidity and outcome in elderly patients undergoing emergency hip surgery: A one‐year follow‐up study
Authors: Shamash K. , O'Connell K. , Lowy M. , Katona C. L. E. 
Published: December 2004

AbstractFifty consecutive elderly patients undergoing emergency hip surgry were assessed shortly after operation and again one year later. Depressive symptoms, cognitive impairment, global physical ill‐health and activity of daily living (ADL) function were assessed and their predictive effect on outcome investigated. Mortality was predicted by the presence of both depression and dementia as well as by physical ill‐health. The effect of depression on mortality was independent of concurrent physical illness. Mortality was particularly high in subjects with both depression and dementia. Length of hospital stay was predicted by increased age and the presence of dementia. Psychiatric evaluation may thus be relevant to the postoperative management of elderly patients undergoing emergency hip surgery.
Psychiatric morbidity among continuing care geriatric inpatients
Authors: Shah Ajit , Phongsathorn Virach , George Collette , Bielawska Celia , Katona Cornelius 
Published: December 2004

AbstractThis study examines the point prevalence of psychiatric morbidity among continuing care geriatric inpatients and the performance of screening questionnaires in detecting such morbidity. From a sample of 74 patients it was possible to carry out complete dementia ratings in 53 patients and depression ratings in 52 patients. Eighty‐three per cent of the patients assessed had dementia and 48% had significant depressive symptoms. Screening for dementia with the Mini Mental State Examination (MMSE) had 100% sensitivity and 78% specificity. The Geriatric Depression Scale (GDS) had 80% sensitivity and 64% specificity at the conventional cutoff of 10/11. Receiver operating characteristics curve analysis suggested that a 12/13 cutoff gave the best sensitivity (75%) and specificity (73%) values for depressive symptoms. Among patients with dementia a cutoff score of 12/13 on the GDS also gave optimal sensitivity, specificity and positive predictive values. The GDS revealed good test–retest stability in the whole sample (tau = +0.55, p < 0.001) and the demented subgroup (tau = +0.52, p < 0.001).
The evaluation of long‐term care for the dementing elderly: A comparative study of hospital and collective non‐medical care in France
Authors: Ritchie K. , Colvez A. , Ankri J. , Ledesert B. , Gardent H. , Fontaine A. 
Published: December 2004

AbstractDespite growing interest in the nature and mechanisms of senile dementia, there has been surprisingly little research on long‐term care provision for persons with irreversible cognitive decline. The present study describes a model for the evaluation of long‐term care facilities for the dementing elderly and its application in France to a comparative study of traditional long‐stay hospitals and non‐medical communal care. Results suggest that persons in communal care are less dependent, report less depressive symptomatology, are more mobile, engage in verbal communication more frequently and have fewer language difficulties than persons in hospital care, although no differences are found between the two groups in terms of dementia severity. Both family and professional caregivers were found to be more satisfied with communal care. A follow‐up study suggests that some of these differences might, however, be due to differences in the populations at admission. The results are discussed in terms of appropriate care allocation for persons with senile dementia.
Concurrent validity of critical flicker fusion in patients with primary degenerative dementia of the Alzheimer type
Authors: Curran Stephen , Wattis John P. , Hindmarch Ian 
Published: December 2004

AbstractThe concurrent validity of critical flicker fusion threshold (CFFT) and flicker threshold measurement was examined in 23 female and three male patients with primary degenerative dementia of the Alzheimer type (PDDAT). Patients had a mean age of 81.7 ± 6.05 years (range 67–89). Diagnosis of PDDAT was based on the DSM‐III‐R classification. Both the CFFT and flicker thresholds were found to be highly and significantly correlated with standardized clinical assessment (Global Deterioration Scale), cognitive function (Abbreviated Mental Test) and psychomotor performance (Choice Reaction Time). The implications of these two measures for clinical trial research and the longitudinal assessment of patients with Alzheimer's disease are discussed.
The impact on carers of behavioural difficulties in dementia: A pilot study on management
Authors: Hinchliffe A. C. , Hyman Inge , Blizard Bob , Livingston Gill 
Published: December 2004

AbstractSixteen day centre attenders with dementia and their carers were interviewed. The cognitive and behavioural impairments of subjects with dementia were assessed using the Mini‐Mental State and the Stockton Geriatric Behaviour Rating Scale. Carers were assessed using the GHQ(28) as a screen for psychiatric morbidity. Where psychological intervention programmes were successful in reducing behaviour identified by carers as particularly distressing, carer GHQ fell. Future studies are needed.
The Hachinski Ischaemic Score: A reevaluation
Authors: Dening T. R. , Berrios G. E. 
Published: December 2004

AbstractThe Hachinski Ischaemic Score (HIS) was first introduced in 1975 as a clinical scale intended to differentiate cases of dementia resulting from multiple strokes (multi‐infarct dementia) from those with primary degenerative dementias. Its conceptual basis rests on the view that vascular dementia is the result of strokes, not of general atherosclerosis or ischaemia. This article critically examines the psychometric properties of the scale. Reliability studies are singularly lacking, and studies of its validity have produced inconsistent findings. Furthermore, there has been a change of views regarding vascular dementia, which is currently seen as heterogeneous and not simply a consequence of strokes. We argue that the HIS is in fact an infarct score, that it is not a true dimensional scale, and that it has outlived its usefulness.
The ability of general practitioners to detect dementia and cognitive impairment in their elderly patients: A study in Mannheim
Authors: Cooper Brian , Bickel Horst , Schäufele Martina 
Published: December 2004

AbstractThe early detection and diagnosis of dementia is gaining in importance both for medical research and for individual case management. Here, a key part can be played by general practitioners, who are in contact with most of the affected old people and well placed to observe any signs of mental deterioration.A study in Mannheim, Germany, is reported, in which all contacts with over‐65‐year‐old patients during one month were documented in each of 24 practices, and each patient's level of memory and cognitive functioning was assessed by his or her own doctor. A stratified subsample of patients in 21 of the practices was examined by the research team, using a standardized interview and test procedure.The findings indicate a greater accuracy of case recognition than has been reported in previous studies. In screening the interview subsample, the practitioners achieved a sensitivity of 92% and a specificity of 76%, identifying most of the mild as well as the severe cases. These results emphasize the potential importance of general practice for the early detection of dementia, and suggest that more attention should now be directed towards the clinical prognosis and management of cases presenting in the primary care setting.
Primary or depressive dementia: Clinical features
Authors: desRosiers Gabriel 
Published: December 2004

AbstractIn 1979, Wells tabled a list of ‘major clinical features’ which he found most useful in distinguishing dementia due to organic disease from dementia occuring in the context of psychiatric conditions like depression. This article reviews recent findings on the most commonly accepted items of this list and, for several of them, concludes that the evidence is controversial. Newer aspects are then briefly considered which, when validated in longitudinal studies, may add to the clinician's range of implements during diagnostic workup.
Keeping track of a conversation: Impairments in Alzheimer's disease
Authors: Alberoni Margherita , Baddeley Alan , Sala Sergio Della , Logie Robert , Spinnler Hans 
Published: December 2004

AbstractEarlier research suggests that AD patients tend to be particularly impaired in the central executive component of working memory, leading to problems in coordinating information from different sources. This suggests that they may be particularly handicapped in keeping track of conversations involving several people. This was studied in 19 AD and 19 matched control subjects. The patients were screened to minimize problems of face recognition and language comprehension and were then shown videotapes of conversations involving from two to five characters. After each tape, a statement made by one of the characters was presented and the subject required to point to the person who had made that statement. Performance was at ceiling for normals, except when the speakers had changed location, when some errors occured. AD patients showed a clear tendency for performance to deteriorate as number of speakers increased, and to show higher error rates when participants changed location. Implications are discussed for AD patients attempting to cope with everyday social situations.
Diagnosis of dementia 3—use of investigations. A survey of current consultant practice, review of the literature and implications for audit
Authors: Byrne E. J. , Smith C. W. , Arie T. , Lilley J. 
Published: December 2004

AbstractThe use of a screening battery of investigations in the assessment of the patient with the dementia syndrome has been recommended by many authorities. A postal survey of hospital specialists showed that the age of the patient influenced their routine use of such batteries. In patients aged < 75 years, their use of investigations closely resembled ‘recommended’ batteries; patients aged > 75 years were much less likely to have a routine screen of investigations. The use of CT scan was much less influenced by the age of the patient. A critical appraisal of the use of investigations in the patient with the dementia syndrome concludes that few of the ‘recommended’ tests will identify the cause of dementia, but will identify conditions which aggravate cognitive impairment, and that further information on the yield of tests, costs of tests, and the results of treating aggravating factors is urgently needed.
Screening for dementia—a comparison of two tests using receiver operating characteristic (ROC) analysis
Authors: Jagger Carol , Clarke Michael , Anderson Judith 
Published: December 2004

AbstractThe abilities of the Mini‐Mental State Examination (MMSE) and the Information/Orientation (IO) subtest of the CAPE assessment to detect a range of severities of dementia were compared by receiver operating characteristic (ROC) analysis. One thousand five hundred and seventy‐nine persons completed the initial screening phase and on the basis of their MMSE score, 438 completed the second stage, a full psychiatric assessment using the CAMDEX (Cambridge Mental Disorders of the Elderly Examination). The IO subtest performed significantly better than the MMSE for detection of moderate and severe dementia. However, for minimal or worse dementia the MMSE showed the best overall performance. Optimal cutpoints for detection of moderate+ dementia were found to be 18/19 (MMSE) and 8/9 (IO subtest) while for mild and more severe dementia these were 22/23 (MMSE) and 11/12 (IO subtest). For both screens the ability of the test to discriminate dementia was significantly impaired for those with physical disability, of manual social class or low educational attainment. The MMSE also performed worse with those aged 80 years and over.
The lifetime productivity of eminent Australian academics
Authors: Christensen Helen , Jacomb Patricia A. 
Published: December 2004

AbstractResearch productivity was examined over the careers of a sample of eminent Australian academics now aged 70–90 years. Overall number of publications increased to a peak at 50–59 years of age and then declined. However, different peaks were observed for various types of publication. Productivity increased to a peak age of 40–49 years for journal articles, 50–59 years for new books and cross‐disciplinary publications, and 60–69 years for revised and edited books, technical publications and non‐technical books. The age of peak productivity for low and high publishers coincided. These effects could be either a consequence of ageing or due to cohort effects in publication practices.
Do old age psychiatrists miss physical illnesses?
Authors: Tench David W. , Benbow Susan M. , Benbow Emyr W. 
Published: December 2004

AbstractWe studied the ability of old age psychiatrists to accurately diagnose physical disorders in elderly patients. A group of 24 psychogeriatric patients who died in hospital were matched for age and sex with 24 elderly patients who died under the care of other specialists in the same hospital. Postmortem findings and premortem diagnoses were compared retrospectively and the two groups showed high but similar levels of diagnostic discrepancies, despite the greater prevalence of dementia in the psychogeriatric group. The results show that old age psychiatrists are as successful as other specialists in identifying physical illnesses in their elderly patients.
Permeable walls, floors, ceilings and doors. Partition delusions in late paraphrenia
Authors: Howard Robert , Castle David , O'Brien John , Almeida Osvaldo , Levy Raymond 
Published: December 2004

AbstractA partition delusion is the belief that people, objects or radiation can pass through what would normally constitute a barrier to such passage. These delusions have been reported to be common in late paraphrenia and late‐onset schizophrenia. Such partition delusions were found in 68% of 50 patients with late paraphrenia, but only in 13% of patients with schizophrenia who had grown old and in 20% of young schizophrenics. Partition delusions, often in association with persecutory beliefs, are common in late paraphrenia and we discuss some possible reasons for this.
A survey of frontal lobe dementia in a psychogeriatric day unit population
Authors: Cole Andrew J. 
Published: December 2004

AbstractNine (12%) of 78 consecutive first admissions to psychogeriatric day units fulfilled an operational definition for dementia of frontal lobe type (DFT). These cases showed many of the behavioural, neuropsychological and neurophysiological features of DFT reported in presenile subjects. They accounted for 14% of first admissions with organic brain syndromes and 37% of those showing marked apathy or disinhibition. These findings support the hypothesis that DFT is a common cause of referral to psychogeriatric services and a significant source of behavioural disturbances in such settings.
Prolactin response to withdrawal of thioridazine in dementia
Authors: McLennan J. , Findlay D. J. , Sharma J. , McEwen J. , Ballinger B. R. , Maclennan W. J. , McHarg A. M. 
Published: December 2004

AbstractThirty‐six female inpatients with a clinical diagnosis of senile dementia of the Alzheimer type were entered into a double‐blind withdrawal of their established thioridazine therapy over a four‐week period. Prolactin (PRL) levels were assayed at weeks 0, 2 and 4 in both groups. A significant reduction in PRL level over this period was seen in the placebo‐substituted group as compared with the active‐continued group. Over the same interval there was no significant change or difference between the two groups in terms of cognitive function, behaviour or physical condition. There was no correlation between PRL levels and degree of dementia or dose of thioridazine at the start of the study. This study suggests that the response to thioridazine withdrawal in senile dementia of the Alzheimer type is a reversal of pharmacological hyperprolactinaemia. The timescale and extent of this can be likened to that seen in schizophrenics and in normal volunteers. No definite evidence emerged that PRL levels might be useful as markers of disease severity or response to neuroleptic therapy.