bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age‐specific prevalence, thyroid dysfunction and depressive symptomatology in adults with down syndrome and dementia
Authors: Prasher V. P. 
Published: December 2004

AbstractTwo hundred and one adults with Down syndrome (DS) were investigated for differing aspects of clinical dementia. Age‐specific prevalence rates of 9.4% for age range 40–49 years, 36.1% for 50–59 years and 54.5% for 60–69 years were found. Findings associated with increasing severity of dementia were gait deterioration, onset of urinary incontinence, increased muscle tone and onset of seizures. No association was found between thyroid dysfunction or thyroid autoimmunity and dementia. However, depressive symptomatology of depressed mood, weight loss and reduced appetite were associated with dementia. These findings investigating Alzheimer's disease (AD) in adults with DS support findings reported for the non‐learning disability population of an association between age, depressive symptomatology and AD but no association between thyroid dysfunction and AD.
A prospective study in three psychogeriatric day hospitals using administrative interventions to improve non‐attendance
Authors: Wright Barry D. , Lunt Bridget , Harris Stephen J. , Wallace Daphne 
Published: December 2004

AbstractThe article reports a survey and a subsequent prospective intervention study. The survey was conducted in two psychogeriatric day hospitals to establish the extent of day‐by‐day non‐attendance. In 1991, 23% of allocated places were not taken up and the reasons for 98% of these episodes are reported. Little attention has been paid to non‐attendance rates in the literature. Their importance is discussed. The prospective intervention study was then conducted using information from the survey year. Administrative interventions, which sought to raise the awareness of patient non‐attendance within the multidisciplinary team, were put into place in the two day hospitals. Non‐attendance rates in a third day hospital, where no intervention was made, were used for comparative purposes. After a second year, non‐attendance in the day hospital with no interventions had fallen by 3%. The other two had each reduced non‐attendance rates by 18%. These reductions have clinical relevance, representing 380 patient days over the whole year in the two day hospitals.
Do general practitioners and old age psychiatrists differ in their attitudes to dementia?
Authors: Wolff Linda E. , Woods Jonothan P. , Reid Jean 
Published: December 2004

AbstractResearch suggests dementia is still underdiagnosed and referral to specialists occurs late and often in crisis, despite increasing evidence that sufferers and carers want early intervention and advice. A questionnaire designed to survey attitudes to dementia was completed by 35 consultants in old age psychiatry across Scotland and a representative sample of 35 general practitioners in Glasgow. The results indicated that general practitioners' and psychiatrists' attitudes to dementia differed significantly in several aspects. The majority of general practitioners felt that they had little to offer dementia patients, that early referral was unhelpful, that easier access to long‐term beds was needed and that the problem was mainly social. In contrast, the majority of consultants supported early referral and diagnosis, strongly felt help could be offered, saw dementia as having both medical and social aspects and were divided regarding ease of admission for continuing care. These differences and possible implications for the delivery of optimum care are discussed.
Alzheimer patients know their date of birth but not their age: A study on disorientation
Authors: Cossa Federico M. , Sala Sergio Della , Spinnler Hans 
Published: December 2004

AbstractTwo experiments on orientation abilities were carried out to investigate whether differences in orientation performances are attributable to the nature of the information to be retrieved, ie to the necessity or not of its continuous updating. In the first experiment, a sample of 112 patients with „probable”︁ Alzheimer's disease (AD/pts) and 112 healthy controls were administered a 14‐item orientation inquiry. AD/pts were most impaired on items which required updating. This finding is interpreted in the light of the different attentional demands made by the two categories of items, namely variant and invariant, and the diminished attentional resources in AD/pts. In the second experiment, the same orientation inquiry was administered to 20 healthy young controls in a dual‐task design. The secondary task called for a continuous attention demanding reaction time. Results indicate that the items which required updating placed the greatest attentional demands. These findings lend support to the hypothesis raised to account for the outcome of the first experiment.
Phenomenologic subtypes in dementia and previous psychiatric hospitalization
Authors: Heinik Jeremia , Berkman Pinhas 
Published: December 2004

AbstractPsychiatric features in dementia may reflect the coexistence of a previous „functional”︁ mental disorder and dementia. To test this hypothesis we used the national Psychiatric Case Register (PCR) as a data source and (a) compared PCR data between phenomenologic subtypes of dementia patients with and without history of psychiatric hospitalization; (b) investigated in what way past psychiatric diagnoses relate to present dementia phenomenology. A small but significant portion of senile (31%) and arteriosclerotic (23%) dementia sufferers did have a documented history of psychiatric hospitalization. No significant or consistent differences concerning PCR demographic, clinical and clinical‐administrative variables studied were found when dementia patients of each subtype, with and without previous psychiatric hospitalizations, were compared. However, phenomenologic subtypes with delusions and depression in senile and arteriosclerotic patients were significantly associated with previous psychiatric „functional”︁ diagnoses of a similar phenomenology. We suggest that, at least in a subgroup of senile and arteriosclerotic dementia patients, the psychiatric subtypes of delusions and depression might reflect the coexistence of two separate mental illnesses.
A randomized, placebo‐controlled trial of thiothixene in agitated, demented nursing home patients'
Authors: Finkel Sanford I. , Lyons John S. , Anderson Rachel L. , Sherrell Kathleen , Davis John , Cohen‐Mansfield Jiska , Schwartz Allen , Gandy James , Schneider Lon 
Published: December 2004

AbstractThe therapeutic efficacy of thiothixene in the treatment of behaviorally agitated dementia nursing home patients was studied in a double‐blind, randomized, placebo‐controlled clinical trial. Thirty‐three subjects were randomized for thiothixene (dose range: 0.25–18 mg) or placebo treatment over an 11‐week period, followed by a 6‐week crossover period to assess for return of symptoms in the group crossed over to placebo and further improvement in the group crossed over to thiothixene. Thiothixene was significantly more effective than placebo in the reduction of agitation at the end of 11 weeks of treatment. Symptoms tended to return after discontinuation. There were no significant changes in the Mini‐Mental State Examination (MMSE) or Activities of Daily Living (ADLs) and no significant differences in side‐effects. Two placebo‐treated patients died, and two patients died after being crossed over from thiothixene to placebo. The results suggest the efficacy of low doses of thiothixene for well‐defined agitation in specifically selected demented nursing home patients.
Apolipoprotein e genotype and late paraphrenia
Authors: Howard Robert , Dennehey John , Lovestone Simon , Birkett Joseph , Sham Pak , Powell John , Castle David , Murray Robin , Levy Raymond 
Published: December 2004

AbstractPatients with late paraphrenia or late onset schizophrenia frequently have associated cognitive impairment which may in some cases progress to a recognized dementia. The frequency of the apoE ϵ4 allele is high in individuals who develop Alzheimer's disease. Twenty‐three patients with late paraphrenia were genotyped for ApoE. The frequency of the ϵ4 allele was comparable with that found in a large group of centenarians, but lower than previously reported from populations of normal controls and Alzheimer's disease patients. Two out of three male patients tested had the rare ϵ2/ϵ2 genotype, which was not found in any of the females.
Physical morbidity in a group of patients referred to a psychogeriatric unit; A 6‐month prospective study
Authors: Perry David W. , Milner Eric , Krishnan V. H. R. 
Published: December 2004

AbstractIn a 6‐month prospective study of all admissions (N = 72) to an old age psychiatric unit, 34% (N = 24) were found to have significant physical illnesses at the time of admission. Sixty‐two per cent of the conditions were detected by a combination of clinical methods and simple tests alone. There was no significant difference in terms of age, sex, marital status or a past history of psychiatric treatment between those who were initially diagnosed as physically ill and those who were physically well at the time of admission. Higher levels of morbidity were found in those with an organic psychiatric diagnosis compared to those with a functional psychiatric diagnosis, although this did not reach a statistically significant level. It is suggested that simple tests can be carried out in the community by family doctors.
The referral, investigation and diagnosis of presenile dementia: Two services compared
Authors: Allen Harry , Baldwin Bob 
Published: December 2004

AbstractThe case notes of 28 patients with presenile dementia presenting to a neurology service were compared with 26 who had presented to a specialist old age psychiatric department (OAPD). Referrals to the former were mainly from hospital doctors for diagnostic purposes. General practitioners referred more often to the OAPD and the patients were older. The reasons were more heterogeneous, but oriented to aspects of practical management of behavioural disturbance. Patients referred to the OAPD were inadequately investigated. It is concluded that specialist old age psychiatric services in Britain have a role in the management of patients with presenile dementia but that diagnosis should be undertaken by neurologists.
Evaluation of a geriatric assessment unit
Authors: Gerritsen J. C. , van Ende P. C. Der , Wolffensperger E. W. , Boom R. Ch. 
Published: December 2004

AbstractPsychogeriatric patients are a very vulnerable group among the elderly. A relative large proportion is institutionalized. In addition, many studies point to the heavy burden on the informal carers of psychogeriatric patients, frequently leading to depression. Geriatric expertise in primary care, however, is limited. To complement this expertise, an experiment was conducted involving a geriatric assessment unit in a nursing home. An evaluation study was carried out including 96 patients, 89 of whom were looked after by informal carers. Data were collected from the unit and two ‘external controls’, both the GP and the informal carer, were interviewed before and 3 months after the intervention. The results show that, in a majority of cases, a new psychiatric or somatic diagnosis could be arrived at. Advice was given on drugs and physiotherapy and the monitoring of behaviour. The impact of the behavioural problems of patients was diminished after the intervention according to the informal carers. Moreover, the sense of competence of the informal carers was enhanced. The health status of the informal carers and the social support they received remained the same. Furthermore, comparison with other datasets supported the assumption of early detection.
Religion and older men in prison
Authors: Koenig Harold G. 
Published: December 2004

AbstractThe objective of the study was to examine the religious characteristics and background of inmates age 50 or over confined to a federal correctional institution. Ninety‐six of 106 eligible inmates (91%) consented and received complete evaluations. Forensic, demographic and health data were collected on all inmates, including detailed information on religious affiliation, background, belief, public and private activities, experience, intrinsic religiosity and religious coping. Over 80% of inmates were currently affiliated with a denomination different from the one in which they were raised, with a net movement from conservative Protestant to mainline traditions. Contrary to expectation, religious characteristics of older inmates were not greatly different from those of non‐incarcerated older adults. There was weak support for a relationship between religiousness and positive forensic factors (first prison term, fewer disciplinary actions). Religion was reported by 32% of inmates to be the most important factor that enabled them to cope. Inmates' intrinsic religiosity and perceived importance of religion to their primary caretaker (person who raised them) were both inversely related to depressive symptoms. This study suggests that religious background, belief, activities, experience and intrinsic religiosity are important factors to the adjustment and behavior of older prisoners.
The prevalence of depression in the carers of dementia sufferers
Authors: Coope Bernie , Ballard Clive , Saad Karim , Patel Abdul , Bentham Peter , Bannister Carol , Graham Candida , Wilcock Gordon 
Published: December 2004

AbstractThe survey aims to evaluate psychiatric morbidity in the carers of dementia sufferers using a semi‐structured psychiatric interview. The case notes of consecutive referrals to four psychiatric services for the elderly in the West Midlands and a memory clinic service in Bristol were reviewed. All referrals who fulfilled the CAMDEX criteria for mild or moderate dementia and had a carer in contact at least once a week were contacted. Participants were assessed using a detailed package which included a Geriatric Mental State Schedule for the carers. More than 90% of those contacted agreed to participate. Altogether 125 patients with dementia were assessed of whom 109 had family members of friends as the main carer. Thirty‐one (28.4%) of the carers had a case level of depression and three (2.75%) had a case level of anxiety. In addition, 36 (33.2%) carers had subcase levels of morbidity. First‐degree relatives showed a trend to be more likely to suffer from depression than friends or more distant relatives. The prevalence of depression was similar among carers in the two different service settings. There was good agreement between AGECAT and RDC diagnosis of depression.
Problem drinking among residents of a VA nursing home
Authors: Joseph Carol L. , Atkinson Roland M. , Ganzini Linda 
Published: December 2004

AbstractThe authors conducted a retrospective study of problem drinking among persons admitted to a Veterans Affairs Nursing Home Care Unit (VA NHCU). Lifetime problem drinking was prevalent in 36% of admissions, two‐thirds of whom had active alcohol problems. Problem drinkers were younger and less often currently married than NHCU residents without alcohol problems. Forty‐seven per cent of persons with active alcohol problems returned to independent living. The results suggest that VA NHCUs may be an important transition between hospital and home for elderly patients with alcohol problems, affording an opportunity for identification and intervention.
The effect of primary care nurse intervention upon older people screened as depressed
Authors: Blanchard M. R. , Waterreus A. , Mann A. H. 
Published: December 2004

AbstractNinety‐six older people were identified as probably suffering from pervasive depression by screening a household‐enumerated population in Gospel Oak Ward, Inner London. They were further assessed by means of the GMS‐AGECAT, and then randomly allocated to either the intervention of community nurse management or normal, local general practitioner care. There were difficulties in implementing recommended changes in the intervention group, in particular the introduction of antidepressant medication and attendance at day centre facilities. Despite these difficulties, an independent assessment 3 months later performed by an interviewer blind to intervention status found that the nurse‐intervened group showed improved depression scores compared to controls. This effect seemed to be greater among the long‐standing cases and was not associated with time spent or number of visits to the subject by the nurse. This community‐based intervention study indicates that depression in older people can be helped by active interventions coordinated and implemented at the level of primary care.
Prevalence and incidence of dementia in the oldest old: A longitudinal study of a population‐based sample of 84–90‐year‐olds in sweden
Authors: Johansson Boo , Zarit Steven H. 
Published: December 2004

AbstractPrevalence and incidence rates of dementia, and the relationship between these rates and mortality, were explored in a longitudinal population‐based study of individuals aged 84–90 at baseline living in the municipality of Jönköping, Sweden. The subjects were reexamined twice at 2‐year intervals using DSM‐III‐R criteria for dementia. The prevalence rate of dementia at time 1 through 3 was: 31% (N=97/312), 40% (N=82/206) and 42% (N=52/123), respectively, which reflects a 4‐years overall increase of age in the sample. The 2‐year incidence was 19.8% from the first to the second wave and 14.9% in the interval between the second and third wave. Of the non‐demented at baseline, 22% (N=48/218) had developed dementia within 4 years. A twofold increased mortality risk was found in demented subjects. The present investigation confirms a high prevalence and incidence of dementia in the oldest old. The substantially increased risk of mortality in demented old olds, however, counterbalances the high incidence rates, keeping prevalence lower than otherwise would be the case.
A survey of memory clinics in the british isles
Authors: Wright Neil , Lindesay James 
Published: December 2004

AbstractThis survey describes the characteristics and activities of 20 memory clinics currently operating in the United Kingdom and Eire. There was broad agreement with regard to aims, objectives and general operating characteristics, but the clinics varied considerably in the number of patients assessed over a given period and in the proportion of cases diagnosed with dementia (15–98%) and Alzheimer's disease (9–80%) in the year prior to the survey.
Characteristics of nursing home patients who receive medications with the potential for addiction on a regular and long‐term basis: A retrospective pilot study
Authors: Solomon Kenneth , Shackson James B. , Brown Barbara W. 
Published: December 2004

AbstractBenzodiazepines are among the most commonly prescribed drugs in nursing homes. Other potentially addictive drugs, including other sedative/hypnotics and oral narcotics, are also prescribed quite frequently. These drugs are not always prescribed for appropriate clinical indications, may be prescribed for extended periods of time and may cause significant side‐effects. Among the concerns about the regular use of these medications is their potential for abuse and dependence. In this study, we examined the records of 253 consecutive psychiatric consultations in nursing homes. All consultations were performed by the senior author. At the time of consultation, one‐third of the subjects were receiving a potentially addictive drug on a regular, and usually daily basis. We compared the group receiving these drugs and the group not receiving these drugs on several variables, including psychiatric and family histories, psychopharmacologic treatments, personal and family addiction histories, psychiatric diagnoses and clinical symptoms. This article presents the results of this study. There were 84 patients in the addictive drug use group and 167 patients in the addictive drug non‐use group. We found that regular use of these drugs was associated with several variables. These included the possibility of a biologic vulnerability to addiction, the presence and severity of the psychiatric disorder(s) of the patients, and the third was the presence of major depression or depressive symptoms. The implications of these data are reviewed. In addition, methodologic and diagnostic issues are discussed. The implications for clinical practice and future research in this area are also discussed.
The relationship between extrapyramidal signs and cognitive function in patients with moderate to severe Alzheimer's disease
Authors: Richards Marcus , McLoughlin Declan , Levy Raymond 
Published: December 2004

AbstractWe studied the association between extrapyramidal signs (EPS) and neuropsychological performance in 137 patients with moderate to severe Alzheimer's disease (AD) residing in a geographically defined area of inner London, UK. The presence of EPS in AD was associated with a distinct neuropsychological profile, suggestive of the additive effect of frontostriatal degeneration. Yet, there was no significant difference in functional capacity between patients with and without EPS. These findings support the hypothesis that EPS represent a parallel independent pathology superimposed over the classical features of AD, rather than providing a marker for global AD severity.
What is a significant score change on the mini‐mental state examination?
Authors: Schmand Ben , Lindeboom Jaap , Launer Lenore , Dinkgreve Marc , Hooijer Chris , Jonker Cees 
Published: December 2004

AbstractThe distribution of change scores of the Mini‐Mental State Examination (MMSE) was assessed in healthy aged subjects after an interval of 1 year. As part of the Amsterdam Study of the Elderly, which is a community survey on ageing and cognitive decline (N = 4051; age range 65–84), a subsample of subjects (N = 247) was studied twice. Participants with dementia, other psychiatric disorders or physical disease which might interfere with cognitive testing were excluded. Test‐retest reliability was 0.55 in this group. The distribution of change scores ranged from −9 to +5. From this result the following clinical rule‐of‐thumb was derived. In an individual patient, and in the absence of other indications of a dementing process, a deterioration in MMSE score must be greater than five points after 1 year to be suspect for a genuine cognitive decline.
A UK national survey of the management of depression by geriatricians and old age psychiatrists
Authors: Orrell Martin W. , Baldwin Bob , Collins Elizabeth , Katona Cornelius 
Published: December 2004

AbstractA national postal questionnaire on the management of depression in the elderly was completed by 89 geriatricians and 72 old age psychiatrists. Significant differences were noted in intended choice of antidepressant drugs (using case vignettes), knowledge of antidepressant drugs and knowledge of psychological treatments. Geriatricians were more likely to suggest dose ranges which were subtherapeutic and were not confident in prescribing newer antidepressants. Very few doctors had overtly negative attitudes towards ageing and depression. However, a need for more training was clearly identified, particularly for geriatricians and for older doctors of both groups. Doctors who were confident about their own abilities tended to also have a more positive approach to therapy and regarded depression as less difficult to treat. Older doctors, geriatricians and those who felt they needed more training in how to treat depression were more likely to use low doses or discontinue treatment too soon after recovery. The results suggest a need for training which focuses on these areas.