bluuebunny/crossref_metadata_2025_split huggingface dataset:
Which elderly depressives will respond to ECT?
Authors: Morris Paul D. 
Published: December 2004

AbstractRecent research has confirmed that ECT is an effective treatment for elderly patients with severe depressive illnesses, but not without some hazard in its administration. The currently available prognostic indicators for ECT have been developed in adults under 65 years old. In this study, the Newcastle ECT prediction scale, the presence of delusions and a scale developed in an elderly population are used to predict response to ECT in a group of 30 elderly depressives. Only the latter is shown to predict responses to ECT. The significance of these findings is discussed.
Assessment of kendrick cognitive tests for the elderly
Authors: Rai G. S. , Phongsathorn V. , Scott L. C. 
Published: December 2004

AbstractThe Kendrick cognitive tests for the elderly were administered to 42 elderly patients with SDAT, 32 normal elderly, 10 patients with depression and 20 elderly patients with multi‐infract dementia. The scores on KDCT and KOLT revealed significant differences between those who had dementia and those who had non‐dementing illness. However, initial test patterns for KOLT and KDCT and test‐retest patterns revealed some overlap. For diagnosis of dementia, if one uses the test‐retest patterns assigned by Kendrick to the various diagnostic categories, the tests have a specificity of 100% and a sensitivity of only 39% thus suggesting that they are of limited value in predicting the presence or absence of dementia in an individual.
The diagnosis of dementia—I clinical and pathological criteria: A review of the literature
Authors: Jane Byrne E. , Smith C. W. , Arie T. 
Published: December 2004

AbstractPathology has been viewed as the gold standard for the diagnosis of dementia. Critical appraisal of the literature suggests that the criteria for pathological diagnosis of Alzheimer's disease vary widely, and that the relative frequency of the various aetiological causes of the dementia syndrome cannot yet be firmly established.
Occult subcortical magnetic resonance findings in elderly depressives
Authors: Churchill Cynthia M. , Priolo Christine V. , Nemeroff Charles B. , Krishnan K. Ranga R. , Breitner John C. S. 
Published: December 2004

AbstractHyperintense signal areas (HSA) on T2‐weighted brain magnetic resonance imaging (MRI) may reflect subtle cerebrovascular insufficiency and are common in elderly depressives. We hypothesized that these HSAs may indicate a vascular etiology for depression in late life, and that patients with late‐onset major depression (MDD) would therfore more often show HSAs than comparably aged recurrent depressives. We reviewed the brain MRI findings of a consecutive series of inpatients aged 50 or over who were treated for MDD during an 18‐month period. Patients with Parkinson's or other brain diseases predisposing to depression were not considered.Twenty‐seven (82%) of 33 patients with depression first apparent in late life and nine (64%) of 14 patients with earlier‐onset recurrent depression showed HSAs. This difference did not reach statistical significance. It was not attributable to the older mean age of the late‐onset group.These rates are in accord with an 86% rate reported in a series of patients referred for ECT (Coffey et al., 1988). They are much higher than the 20–30% figure for comparably aged normals (Bradley, 1984; Kirkpatrick and Hayman, 1987). HSAs were common in this series of elderly depressed inpatients, regardless of age of onset of illness.
Palatability of liquid major tranquillizers
Authors: Gibson P. , Mountjoy C. Q. , Sutcliffe R. L. G. 
Published: December 2004

AbstractThose with mental disorder in later life may reject medication for various reasons. In the case of liquid medication this may be due not to mental disturbance or swallowing difficulty but to unpalatability of the medication. Thirty volunteers blind‐tasted four major tranquillizer liquid medications and a palcebo.Not one of the active preparations was thought to be pleasant, each being associated with bad immediate or delayed taste.Undesirable taste may be a valid cause for rejection by patients of any age. As liquid medication is prescribed more frequently for elderly than for younger patients, palatability should be considered.
A comparison of clinical, psychometric and behavioural memory tests: Findings from a community study of the early detection of dementia
Authors: Beardsall Lynn , Huppert Felicia A. 
Published: December 2004

AbstractDiagnostic criteria for dementia require assessment of the ability to learn new information. Ideally, this assessment should be brief and sensitive to early impairment. We present comparative data on a variety of memory tests administered to a population sample of elderly community residents who are being studied longitudinally. Of the three classes of memory tests, clinical, psychometric and everyday tests, discriminant function analysis indicated that, overall, the best discrimination between demented and non‐demented individuals was achieved by some everyday tests: recalling a news item, retracing a route, and recalling a name after learning a name‐photograph association. However, of the 11 tests examined in total, two were identified which together discriminated almost as efficiently as all 11 measures combined. These were recalling a name and recalling six objects. By comparison, the principal memory item in the Mini Mental State Examination, the recall of three words, produced poor discrimination. The two simple measures which provided good discrimination in this population sample may therefore be recommended to assess the ability to learn new information, where the aim of the assessment is the diagnosis of dementia.
The validity of memory complaints by elderly persons
Authors: Christensen Helen 
Published: December 2004

AbstractMemory complaint and objective test performance were assessed in 20 elderly ‘memory complainers’, 11 elderly controls, 14 young students, and 19 mildly‐to‐moderately demented patients using an everyday memory questionnaire and clinical memory tasks. Consistent with earlier studies, memory complainers as a group reported more failures of everyday memory but did not differ from the controls on the clinical memory tasks. However, on further analysis, memory complaint and poor test performance were positively associated; first, in those elderly subjects who considered their memory impairment to be both worse than their peers' and recently acquired; and secondly, in individuals whose level of memory performance was lower than that expected on the basis of their ‘premorbid intelligence’. The latter finding indicates that a legitimate basis for memory complaint is more often present in complainers than non‐complainers.
The assessment of orientation in dementia: Item content versus item format
Authors: Hopkins R. W. , Rindlisbacher P. 
Published: December 2004

AbstractOrientation assessments with regard to time, place and person tend to show a typical pattern of deterioration in progressive dementias. Some clinicians have established hierarchies of orientation based on these observed paterns. There are discrepancies in the order of these hierarchies, due perhaps to differences in the phrasing of questions asked of patients. It is possible to vary the difficulty of items by changing the question format and evidence is cited to show that format differences may be especially pertinent to demented populations. In two large samples of psychogeriatric subject frequencies of incorrect responses for individual orientation items were calculated along with probabilities of success based on chance responding. Results show that although the traditional contentbased hierarchy was observed, simple probabilities of success could also account for the observed frequencies of incorrect responding.
Reliability of flicker threshold measurement in patients with primary degenerative dementia of the Alzheimer's type (PDDAT)
Authors: Curran S. , Wattis J. P. , Hindmarch I. 
Published: December 2004

AbstractThe test‐retest and split‐half reliability of flicker threshold measurement was determined in 23 female and three male patients with primary degenerative dementia of the Alzheimer's type (PDDAT). Patients had a mean age of 81.7 ± 6.05 years (range 67–89). Diagnosis of PDDAT was based on DSM‐IIIR criteria. The psychophysical method of limits was used to determine the flicker threshold and was the average of four separate measurements. The split‐half reliability was found to be 0.97 and the test‐retest reliability 0.941 (both p < 0.0001). The measurement of flicker thresholds is a quick, easy and reliable technique in patients with PDDAT. Future work will also need to examine the validity and pharmacosensitivity of the measure if it is to be used to assess potentially therapeutic agents for the management of the underlying disease process.
Binswanger on Binswanger's disease
Authors: Forstl Hans , Howard Robert , Levy Raymond 
Published: December 2004

AbstractIn 1894 Otto Binswanger described a disease of the hemispheric white matter which he called encephalitis subcorticalis chronica progressiva'. He examined eight patients who had shown a slow but relentless cognitive decay that began in middle or old age and lead to severe dementia, characterized in the early stages by a disturbance of association of cortical sensory and motor areas, by aphasia, hemiamblyopia, hemianopia, hemiparesis and a loss of the sense of pressure, position and touch. At postmortem the patients showed white matter atrophy most pronounced in the temporal and occipital lobes. Binswanger proposed that this subcortical fibre loss was due to cerebral arteriosclerosis, which was almost invariably demonstrated. “Binswangers” disease' has gained topical importance following the introduction of sensitive imaging techniques which have led to the frequent detection of white matter disease during life. This full account of his original observations may contribute to the clarification of contemporary terminological issues.
Life satisfaction and associations with social network and support variables in three samples of elderly people
Authors: Bowling Ann , Farquhar Morag , Browne Peter 
Published: December 2004

AbstractResearch evidence concerning the contributions of social networks and support to the subjective wellbeing (ie life satisfaction) of older persons is not consistent. This article reports the results of an investigation of social network type and health status and their effects on life satisfaction in relation to 1415 elderly people from three independent but comparable surveys: two in City and Hackney, London (urban area) and one in Braintree, Essex (semi‐rural area). The percentages of the total variation in overall life satisfaction which was explained by the model ranged from 22% to 33% between samples. The most variation was explained among the sampleaged 85+ living in inner London. Although most of the variance remains unexplained, healthstatus was a more powerful predictor of life satisfaction among respondents living in City and Hackney, but not those living in Braintree.
Psychiatric morbidity as predictor of mortality for residents of local authority homes for the elderly
Authors: Ashby Deborah , Ames David , West Christopher R. , MacDonald Alastair , Graham Nori , Mann Anthony H. 
Published: December 2004

AbstractThe residents of 12 local authority homes for the elderly run by one London borough were screened for depression and dementia in 1982 and again in 1985/6. Both samples were followed up 8–16 months after screening. In both groups, 23% were dead at follow–up and a small percentage (2% in the first sample, 5% in the second) had moved to hospitals. The mortality was approximately twice that expected for the general population of the same ages and was associated with male sex, young age, high organic brain syndrome score, high depression score, and the expression of a wish to die when screened. The majority of deaths were certified as due to chest infection or cardiovascular disease. The term “dementia” appered on only 18 of 99 death certificates, although 58 of these 99 residents had been classed as demented when screened. This study provides further evidence of the malign prognosis of depressive and cognitive disorder among residents of these homes.
Three‐year follow‐up study of nursing home residents using rating scales in Japan
Authors: Nagatomo Itsugi , Nomaguchi Mitsuo , Fukuzako Hiroshi , Matsumoto Kei 
Published: December 2004

AbstractOne hundred and nine nursing home residents were examined by the modified Stockton Geriatric Rating Scale (modified SGRS) and the Hasegawa Dementia Rating Scale in April 1987. Twenty‐eight residents died during the three‐year period. The 64 survivors remaining at the nursing home were reexamined in April 1990 and were divided into two groups according to whether they had been admitted to hospital or not during the follow‐up period. Physical ability as measured by the modified SGRS and the Hasegawa Dementia Rating Scale had deteriorated in both groups, and communication failure and apathy on the modified SGRS were aggravated in the admitted group. It is considered that not only the physical care of all nursing home residents but also the psychogeriatric care of residents with severe physical impairment is necessary.
Further evidence of preserved memory function in Alzheimer's disease
Authors: Scott L. C. , Wright G. K. , Rai G. S. , Exton‐Smith A. N. , Gardiner J. M. 
Published: December 2004

AbstractMemory performance of elderly patients in the early stages of Alzheimer's disease (DAT) was compared with that of elderly control subjects. In explicit tests of recognition memory, which involve conscious recollection, the DAT patients were grossly impaired. In implicit tests of anagram solution and wordstem completion, which do not require conscious recollection, the DAT patients were not impaired. These findings further support the idea that a separate memory system, episodic memory, underlies conscious recollection, that it is this system which is most commonly damaged in amnesia, and that memory systems not involving conscious recollection may be spared in the early stages of Alzheimer's disease.
The ageing of the third world: tackling the problems of community surveys. Part II: A community survey of the elderly population in rio de janeiro: a methodological approach
Authors: Veras Renato P. , Murphy Elaine 
Published: December 2004

AbstractThis article (Part II) introduces a joint project being carried out at the Institute of Social Medicine, Rio de Janeiro, and the United Medical and Dental Schools, Guy's Hospital, London, concerning the epidemiology of the elderly population of Rio de Janeiro. The methodology used and the stages of the community survey are presented. The sampling methods and the steps of the enumerator process are detailed, and the design on the reliability and validity study of mental health is also presented. The main purpose of this article is to present the methodological approach.
Prevalence of dementia in an urban slum population in thailand: Validity of screening methods
Authors: Phanthumchinda Kammant , Jitapunkul Sutthichai , Sitthi‐amron Chitr , Bunnag Srichitra C. , Ebrahim Shah 
Published: December 2004

AbstractA randomly selected sample of 500 subjects over 60 years old and their relatives were studied using standardized methods for assessment of cognitive impairment. The prevalence of DSM‐III‐R dementia was 1.8% (95% confidence intervals 0.6‐3%), and the majority of cases had a probable diagnosis of Alzheimer's disease. The sensitivity and specificity of the field survey version of the Mini‐Mental State Examination (MMSE) for a diagnosis of dementia using a threshold of 21 were 100% and 53% respectively. This was associated with a positive predictive value of dementia, given a low score, of only 3%. A high prevalence of low MMSE scores was found: 23% of men and 50% of women had scores below 21, and there were strong relationship between low scores and age. Strong associations between low MMSE scores and no education were found, and weaker associations with female sex, deafness and poor sight. The MMSE is markedly affected by educational level, which together with its low positive predictive value for dementia in this population makes it a poor screening of research tool. A Behaviour Rating Scale score had a higher specificity leading to fewer false positives, but only achieved a sensitivity of 67%. In populations with low levels of education it is recommended that behavioural disabilities scales should be developed as a means of screening for dementia syndromes.
Brain imaging in late‐onset schizophrenia and related psychoses
Authors: Krull Alice J. , Press Gary , Dupont Renee , Harris M. Jackuelyn , Jeste Dilip V. 
Published: December 2004

AbstractIn this article we review the published studies on brain imaging in late‐life psychoses, and present data from our study of magnetic resonance (MR) imaging of the brain in late‐onset schizophrenia (LOS). MR images were obtained in 11 patients with late‐onset schizophrenia (LOS), nine patients with probable Alzheimer's disease (AD), and nine normal controls comparable in age, gender, and education. Two of the LOS patients were excluded from further analysis due to the presence of diagnosable organic pathology (i.e. Alzheimer's disease and presence of a subaracnoid cyst). The MR images were subjectively rated for both degree of ventricular enlargement (VE) and degree of abnormal white matter hyperintensities (WHM) by an experienced, board certified neuroradiologist in a blind manner. No significant differences were found among the groups on degree of abnormal WHM. MR images of AD patients had a significantly greater degree of VE than normal controls, with LOS patients being intermediate. Our data, for LOS and have evidence of non‐specific abnormalities in brain morphology on MR imaging, yet do not have clinical or MR imaging evidence of a specific organic etiology for psychosis.
Influence of ageing and concurrent psychotropic drugs on dementhylation of tertiary tricyclic antidepressants
Authors: Leinonen Esa , Ylitalo Pauli 
Published: December 2004

AbstractThe effects of ageing and concurrent psychotropic durgs on demethylation degree of tertiary tricyclic antidepressants (TCAs) were studied in 340 psychiatric inpatients with depression. They were treated daily with routine therapeutic doses of doxepin (177±59 mg, mean ± SD) or amitriptyline (154±47 mg). The numbers of blood samples analysed gas chromatographically for serum concentrations of tertiary TCAs and their secondary amine metabolites were 340 for doxepin and 192 for amitriptyline. The patients were divided into three age groups: >35, 35‐65 and <65 years old. Serum concentrations of doxepin and amitriptyline were increased significantly or showed a trend towards an increase with advancing age, but the concentrations of secondary amine, TCAs did not increase at all in the elderly. The ratio of secondary/secondary + tertiary amine TCAs was generally decreased with ageing. Concurrent neuroleptics, but not benzodiazepines, frequently increased the percentage fraction of secondary amine TCAs. We conclude that the altered demethylation ratio of tertiary amine TCAs, conceivably favouring the altered profile of drug action, should be considered when serum TCA concentrations are monitored in the eldrly and with concurrent neuroleptic therapy.
Objective assessment of praxis‐the oap diagram:‐simply testing for dementia
Authors: Connelly Peter J. , Jamieson Fiona E. 
Published: December 2004

AbstractCognitive assessment schedules for the elderly are often complex, cumbersome or highly dependent on memory function. Performance on visuoconstructive tests, which are often easily undertaken, is not dependent on ‘dominance’ of either hemisphere. Unfortunately, such tests often have complex objective and subjective scoring criteria, making standardization difficult. We have designed a structured diagram and scoring system which proved simple to administer and score and performance on which correlated well with intellectual function on the CAPE, while, unlike the Gibson Spiral Maze (GSM), those without dementia tended not to make any mistakes. Scoring on the GSM was also affected by age and the presence of parietal signs to a greater extent than the OAP, suggesting that the GSM may overestimate cognitive impairment in the population for which it was designed. Some possible uses for the OAP as a new test in the assessment of the elderly are discussed.
Psychotic symptoms in Alzheimer's disease
Authors: Cooper James K. , Mungas Dan , Verma Maxine , Weiler Philip G. 
Published: December 2004

AbstractMemory loss is the hallmark of Alzheimer' disease. However, psychotic symptoms have also been reported. We studied the prevalence of hallucinations and delusions in 677 subjects with probable Alzheimer' disease. Data were collected in six centers and analyzed retrospectively. A two‐stage, multivariate approach was used. The overall prevalence of these psychotic symptoms was 31%. The prevalence of hallucinations was 17%, and of delusions 26%. Both were associated with emotional incontinence, insomnia and agitation as well as with advanced disease. While psychotic symptoms were more prevalent in advanced disease, nonetheless they occurred with notable frequency in early disease. Of subjects with early AD (MMSE scores between 21 and 30), 6% had hallucinations and 17% had delusions. Alzheimer' disease must be considered in the differential diagnosis of any subject over 55 presenting with these psychotic symptoms.
The prediction of stress in carers: The role of behaviour, reported self care and dementia in patients with idiopathic Parkinson's disease
Authors: Calder Sheila A. , Ebmeier Klaus P. , Stewart Lesley , Crawford John R. , Besson John A. O. 
Published: December 2004

AbstractStress scores were elicited from relatives living with Parkinsonian patients and correlated with various aspects of the patients' impairment. The (usually female) relatives looking after male patients reported higher levels of stress than husbands looking after their wives. In general, the best predictor of relatives' stress was the behavioural rating scale of the CAPE and a reported selfcare scale designed for the study. The relative contribution of Parkinsonian motor impairment and cognitive impairment to relatives' stress scores was examined. While motor impairment was still associated with relatives' stress after controlling for sex and cognitive deterioration, both dementia and cognitive impairment measured by the Mini‐Mental State Examination were not associated with relatives' stress if Parkinsonian disability was controlled for.
F. H. Lewy on Lewy bodies, parkinsonism and dementia
Authors: Föorstl Hans , Levy Raymond 
Published: December 2004

AbstractF. H. Lewy (1885‐1950) recognized characteristic globoid and elongated inclusions with a surrounding halo (Lewy bodies) in the nervecells of the dorsal nucleus of the vagus and in Meynert's nucleuls basalis of patients with shaking palsy. Excerpts of his influential publications from 1912 and 1913 are translated. In 1923 he published a monograph which contains neurological, psychiatric and neuropathological data about 43 patients with Parkinsonism; 21 were demented, 10 had affective disturbances and 12 were considered as mentally normal. Alzheimer tangles and/or plaques were found in the cortices of 12 patients. Structures corresponding to Lewy bodies were described in the brains of 13 patients, but only once in the neocortex. Lewy's original work may deserve interest in view of current research on the prevalence and nature of the Lewy body and the nosological confusion caused by its rediscovery.