bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in elderly physically ill inpatients: A 12‐month prospective study
Authors: Evans Mavis E. 
Published: December 2004

AbstractA 12‐month prospective study of a randomly selected group of acute geriatric medical inpatients was carried out. Twenty‐three of the original sample of 72 were diagnosed as cases of depression on entry into the study and commenced on treatment with fluoxetine 20 mg mane. Follow‐up at 3 months showed a significantly increased death rate in the depressed group (p < 0.05) which was reversed in those surviving to 12 months, this trend to a lower mortality not reaching significance. Two patients did not continue their antidepressants after leaving hospital and remained depressed at 3‐month follow‐up. The effect of treatment versus no treatment was significant (p < 0.03). The incidence of depression in the psychologically well group was 14% over the 12‐month period, understandably high when seen in the context of their continuing physical problems. None of the treated depressed group relapsed during the study period.
Deliberate self‐harm in the elderly: A survey of one London Borough
Authors: Nowers Mike 
Published: December 2004

AbstractThis article details the results of a retrospective case note study on deliberate self‐harm in the elderly in the London Borough of Tower Hamlets. There were 56 females and 32 males included in the study. The ages of the patients ranged from 65 to 90. Fifty‐seven per cent of the sample had a depressive illness, most commonly found in the younger females and the older males. Over 50% of the sample had evidence of multiple health problems, particularly heart disease and arthritis. Over 90% of cases used self‐poisoning as the means of self‐harm. Sixty‐one per cent used benzodiazepines and 25% salicylates. Over 30% used multiple drug combinations. Thirty‐eight per cent of the sample had evidence of previous self‐harm, 17% had repeated self‐harm within a year and 6% were dead through suicide. Although the characteristics of the patients bore some resemblance to those identified in the literature as being risk factors for self‐harm among younger patients, they bore a much closer resemblance to known risk factors for suicide. This may have ramifications for further research into the prevention of suicide.
Sexual problems associated with dementia: Part 2. Aetiology, assessment and treatment
Authors: Haddad Peter M. , Benbow Susan M. 
Published: December 2004

AbstractPhysical, psychological and social factors need to be considered in the aetiology and treatment of sexual problems in people with dementing illnesses. Treatment may raise ethical dilemmas and involve value judgements. Assessment within a multidisciplinary framework is therefore recommended.
Performance of the Italian version of the mini‐mental state examination in day hospital geriatric medical patients
Authors: Turrina Cesare , Dewey Mike E. , Siani Roberta , Saviotti Francesco , Marchione Nicoletta , Siciliani Orazio 
Published: December 2004

AbstractThe criterion validity of the Italian version of the Mini‐Mental State Examination was tested in a group (114) of elderly medically ill day patients. Specificity was rather disappointing (66.3%) at the conventional threshold (23/24), as well as positive predictive value (32.7%). A lower threshold (21/22) offered the best compromise between sensitivity (93.8%) and specificity (80.6%). ROC analysis evidenced a good overall performance of MMSE (area under the curve 0.938). In those subjects not affected by dementia, age, low education and depressive illness had a significant effect on MMSE scores.
Blood flow velocity waveform in the common carotid artery in advanced age and clinical outcome—A 1‐year follow‐up
Authors: Nagatomo Itsugi , Nomaguchi Mitsuo , Matsumoto Kei 
Published: December 2004

AbstractWe investigated the common carotid arterial blood blow in 70 patients of advanced age (80 and older) in a nursing home using an ultrasonic quantitative blood flow measurement system. Systolic and end‐diastolic velocities were obtained from the waveform, and using these two velocities, subjects were classified into three groups according to increasing severity. We then determined mortality rates and changes in the modified Stockton Geriatric Rating Scale (SGRS) over a 1‐year period. The mortality of group 1 was significantly lower than that of group 3. The groups with more severely impaired carotid blood flow also demonstrated as groups change in the sequence 1→2→3a worsening on some subscales of the modified SGRS over the year. These results suggest that carotid arterial blood flow velocity waveform can serve to predict some aspects of clinical outcome in very old age.
Assessments of productivity of psychogeriatric day care
Authors: Wimo A. , Ineichen B. , Mattson B. , Kallioinen M. 
Published: December 2004

AbstractAlthough psychogeriatric day care has been established since the 1950s, few studies have focused on its productivity. In this study, nine assessments of productivity are presented and tested on 74 patients in psychogeriatric day care in Sundsvall, Sweden. The participation quotient was 68%, the capacity quotient 76%, and the registration quotient 112%. The mean attendance was 1.6 visits a week and the average turnover was 31% during 6 months. Six patients out of 74 (8.1%) were institutionalized at the end of the 6‐month period and the mortality was 1.4% (1/74) during 6 months. The misjudgement quotient was 12.2% for the 6‐month period. The patients' refusal to attend DC was the most frequent reason for discharge.
Paranoid disorders in the elderly
Authors: Grief Cindy , Eastwood Robin M. 
Published: December 2004

AbstractAssigning paranoid diagnoses in the geriatric population can be a challenging endeavour. A survey was undertaken of selected ICD‐9 diagnoses in different hospital settings. Almost 50% of the diagnoses were associated with combative/paranoid behaviour; yet, only 12% received ‘paranoid’ diagnoses. This article addresses the problems of case definition for paranoid states in the elderly.
The treatment of diffuse lewy body disease: A pilot study
Authors: Williams S. W. , Byrne E. J. , Stokes P. 
Published: December 2004

AbstractSingle case studies may provide useful information and generate hypotheses for later testing in group studies. The effect of anti‐Parkinsonian medication is reported in five individual cases of diffuse Lewy body disease. The problems caused by the variability in congnitive function and psychiatric symptoms in these cases are outlined together with suggested strategies for future research.
The rabbit syndrome: Occurrence in a neuroleptic naive patient
Authors: Kelvin Raphael , O'Brien John , Dening Tom 
Published: December 2004

AbstractAn elderly woman presented with a severe depressive disorder and moderate cognitive impairment. She had a dyskinesia of the rabbit syndrome type, but in contrast to previous reports she had not previously been treated with neuroleptics. We believe this to be unique in the literature. Further, we speculate about the possible association of the rabbit syndrome and senile dementia of Lewy body type.
Medical outcome of psychosocial intervention in demented patients: One‐year clinical follow‐up after relocation into group living units
Authors: Annerstedt Lena , Gustafson Lars , Nilsson Karin 
Published: December 2004

AbstractCare of demented elderly in group living units is developing rapidly in Sweden. Group living (GL) offers a secure, small‐size, homelike physical setting and an individualized, psychosocial and integrity‐promoting therapy. Twentyeight patients suffering from dementia of Alzheimer type (DAT) or/and vascular dementias (VD) were evaluated before relocation from traditional long‐term care institutions (TI) into GL units and followed up 6 and 12 months later by psychogeriatric ratings, regional cerebral blood flow measurements, somatic investigations and registration of pharmacological treatment. The patients relocated into GL were compared to a matched sample of 28 patients permanently cared for in TI. GL patients showed less dyspraxia, dysphasia and less prominent symptoms of depression and anxiety after both 6 and 12 months compared to the control group. Restlessness diminished among GL patients while the patient group in TI got more restless. Neuroleptic treatment was found to be used significantly more often among the TI patients during the whole study and anxiolytic‐hypnotic treatment after 6 months. No difference was observed in antidepressive treatment. The results show that psychosocial stimulation and therapy offered in GL care has positive effects on emotional symptoms and performance compared to care in TI. These clinical changes abate later in the study as a consequence of the underlying organic disease. The major benefit of GL was slightly different between the diagnostic groups: for VD patients improvement of practical abilities, for AD patients abated agitation and restlessness.
Dementia, awareness and depression
Authors: Verhey Frans R. J. , Rozendaal Nico , Ponds Rudolf W. H. M. , Jolles Jellemer 
Published: December 2004

AbstractWe examined 170 outpatients, 103 with Alzheimer's disease, 43 with vascular dementia and 24 with various other causes, in order to investigate whether or not depressive symptoms were more likely to occur in dementia patients who had some degree of awareness of their cognitive deterioration. Awareness was rated on a four‐point scale that assessed discrepancies between the patient's and the caregiver's history. The level of awareness was significantly related to the severity of dementia but not to depression or to the score on Hamilton's depression scale. However, the score from the item “psychic anxiety” showed a weak but significant correlation with the level of awareness of one's deficits. It is concluded that intact awareness of deterioration was not clearly related to the development of depression or depressive symptoms in dementia.
Continuity and discontinuity in Dementia
Authors: Dening Tom 
Published: December 2004

AbstractRecent evidence from epidemiological studies has been used to suggest that dementia represents the extreme of a continuous distribution of normal ageing, rather than being a qualitatively distinct disease entity. In contrast, clinicians, who are asked to advise about individual cases, assign patients to diagnostic groups, thereby using a categorical model of dementia. This article argues that both approaches are models, and therefore neither is ‘correct’. Each model has its strengths and limitations, and the choice of which model to apply should depend on which is more appropriate to the issues under consideration. Clinicians do not need to be apologetic about using dementia as a category as long as they are aware of the limitations of this approach.
HPA axis function in depression and dementia: A review
Authors: O'Brien John T. , Ames David , Schweitzer Isaac 
Published: December 2004

AbstractThis article reviews recent advances in the understanding of hypothalamic‐pituitary‐adrenal (HPA) dysfunction in depression and dementia. Although the dexamethasone suppression test (DST) has proved disappointing as a diagnostic test, more recent tests of HPA axis function have not yet been adequately investigated in this regard. There is mounting evidence from both animal and human studies that a complex interrelationship exists between mood, age, cognitive function, brain structure and HPA axis dysfunction. To explore this relationship further, studies combining clinical, neuroimaging and neuroendocrine investigation are required.
Onset of seizures as a poor indicator of longevity in people with down syndrome and dementia
Authors: Prasher V. P. , Corbett J. A. 
Published: December 2004

AbstractAn association between Down syndrome and dementia of Alzheimer type is well established. This study demonstrates that late onset seizures in people with Down syndrome are a strong indicator of a dementing process. Further, late onset seizures in people with Down syndrome may be used as a prognostic indicator, indicating life expectancy of less than a further 2 years, probable death within 3 years and death almost invariably within 5 years of onset.
Cognitive impairment in the elderly medically ill: How often is it missed?
Authors: Ardern Mark , Mayou Richard , Feldman Eleanor , Hawton Keith 
Published: December 2004

AbstractOne hundred and sixty‐three patients over 65 years of age admitted to the acute medical wards of a district teaching hospital were studied for prevalence and type of cognitive impairment. Findings from research assessments, where possible using a cognitive rating scale, were compared with detection of impairment by medical and nursing staff involved in patients' clinical management. 30.7% of patients were judged by us to show definite or probable cognitive impairment, a figure substantially higher than that detected by hospital staff. Outcomes in terms of death, duration of admission and discharge location were related to the presence or absence of cognitive impairment and whether impairment was due to delirium, dementia or a mixed syndrome. The low rate of detection of cognitive impairment is discussed, and suggestions made to improve detection in acute elderly medical inpatients.
The eugeria study of cognitive ageing: Who are the ‘normal’ elderly?
Authors: Ritchie Karen , Ledésert Bernard , Touchon Jacques 
Published: December 2004

AbstractA cross‐sectional study of the cognitive performance of 575 normal elderly persons suggests considerable heterogeneity at each age level. While a number of cognitive functions (articulation, reading, semantic matching, comprehension of syntax and implicit memory) showed no difference with age, explicit memory, and other linguistic and visuospatial capacities, were significantly poorer, especially over 80 years. Within this normal population an ‘unstable’ subgroup showing significant deterioration in everyday performance according to an informant questionnaire was found to differ significantly on cognitive testing from elderly persons who had remained stable over this period. The ‘unstable’ group was also found to have a higher prevalence of depressive symptomatology and depressive illness. The question is raised as to whether ‘instability’ over time may be a very early indicator of subclinical pathology. The importance of taking such a group into account in the interpretation of studies of cognitive functioning and senile dementia is also discussed.
Neuroleptics in the treatment of psychosis in late life: A rational approach
Authors: Mulsant Benoit H. , Gershon Samuel 
Published: December 2004

AbstractScientifically assessing the therapeutic benefits of neuroleptics in the treatment of psychoses occurring in late life would require answering two related questions: to what extent are dopaminergic mechanisms at the core of these disorders, and to what extent is the dopaminergic blockade of neuroleptics essential to their beneficial effects? Given the dearth of relevant scientific data, the use of neuroleptics in the treatment of late life psychoses remains justified mostly by extrapolations from data obtained in younger patients and by results of empirical trials in older patients. Based on a careful examination of these data, this article reviews the nosology of the late life psychotic disorders and proposes a rational approach to the use of neuroleptics in their treatment. Suggestions for future research are made.
Outcome of depression in demented and non‐demented elderly: Observations from a three‐year follow‐up in a community‐based study
Authors: Forsell Y. , Jorm A. F. , Winblad B. 
Published: December 2004

AbstractIn the Kungsholmen project, a longitudinal study of a total population, samples of non‐demented and demented elderly persons with a depressive disorder were followed over 3 years. Of 668 persons who received a full medical examination, 62 were found to have a depressive disorder. Of these, 28 were demented and 34 non‐demented. Two‐thirds of the 62 had not been previously recognized as having a depressive disorder. There was no difference in this regard between the demented and non‐demented samples. After 3 years, only two out of 20 non‐demented cases had recovered from their depressive disorder. This is in contrast to the demented cases, where only one of 11 were still depressed. These results indicate the need for greater attention to the recognition and management of depressive disorders in the elderly.
Risk factors among incident cases of dementia in a representative british sample
Authors: Morgan Kevin , Lilley Jeanette M. 
Published: December 2004

AbstractIn a 4‐year follow up of 1042 elderly people (aged 65+) randomly sampled from the community, levels of dementia were assessed using a two‐phase case‐finding procedure (screening followed by clinical interview) among survivors, with additional information provided by death certificates, hospital case notes or postal questionnaires. Overall, 42 cases were clinically identified. In a case‐control analysis matching for age, sex and premorbid cognitive status, risk estimates were obtained for nine self‐reported factors: heart trouble; headaches; giddiness; falls; current smoking; past smoking; left handedness; insomnia; and the use of sedative‐hypnotic drugs to promote sleep. While none of these factors was associated with a significantly increased risk, the power of these case‐control comparisons was limited by sample size.
Falls among community‐dwelling psychogeriatric patients
Authors: Asada Takashi , Kariya Tetsuhiko , Kitajima Eiji , Kakuma Tatsuyuki , Yoshioka Mitsuru 
Published: December 2004

AbstractAlthough increasing interest has been focused on falling in the elderly, little is known about the incidence and consequence of falls in psychogeriatric outpatients. We conducted a 1‐year prospective study of falling in 102 community‐dwelling elderly patients with psychiatric morbidity (mean age: 70 years) and 100 mentally intact elderly patients (controls, mean age: 74 years). The subject group comprised 79 patients with depression, 14 with dementia and nine with combined disease based on DSM‐III‐R criteria. Overall, 216 falls in the subject group and 54 in the controls were reported. At the end of the study, recurrent fallers aged 75 years and older showed significant physical deterioration. Multiple logistic regression analysis of selected medical and demographic variables indicated that the most influential variable regarding falling of the subjects was severity of depression rated using the Hamilton scale. Unexpectedly, the analysis revealed that the use of antidepressants was associated with a lower likelihood of falling. On the basis of the two variables, 75% of all respondents were correctly classified as fallers or non‐fallers.
Autopsy services for old age psychiatrists in England and Wales: A survey of consumer satisfaction
Authors: Benbow Emyr W. , Benbow Susan M. , Reid Helen 
Published: December 2004

AbstractAnecdotal evidence suggests that some old age psychiatrists are dissatisfied and disillusioned with their local autopsy services, and so we carried out a postal survey to assess the extent of the problem. Our most striking finding was that over a quarter of old age psychiatrists are, indeed, dissatisfied with the way other organ systems were examined. This dissatisfaction is very strongly associated with services where autopsies on psychogeriatric patients are carried out by general histopathologists, especially where there is no established facility for the brain to be preserved and subsequently examined by a neuropathologist. The main complaint about neuropathologists was that reports sometimes took an unacceptable length of time to be returned to the clinician. The solution to the difficulties experienced by old age psychiatrists would be a closer association with their local neuropathology services, but whether neuropathologists are in a position to increase their workloads remains to be determined.
Evaluation of early dementia by a trained nurse
Authors: Seymour Jeremy , Saunders Peter , Wattis John P. , Daly Lynn 
Published: December 2004

AbstractPatients tend to get referred to psychogeriatricians late in the course of a dementing illness, often when a crisis has occurred and carers can no longer cope. Earlier referral is disirable, but generates extra work for the psychogeriatrician. Nurse screening may overcome this. In this study a nurse, trained in the administration of the CAMDEX structured interview and supervised by a psychogeriatrician, performed a diagnostic assessment on patients with early cognitive impairment referred from primary care. This initial phase of the study sought to validate the nurse's assessment, and found that in 33 patients with possible early cognitive impairment, there was good broad agreement between the nurse's diagnosis and a psychogeriatrician's diagnosis supported by standardized rating scales. Nurse screening may be a cost‐effective means for a secondary care psychogeriatric service to provide support to general practitioners, form a case register of patients with early dementia, and follow these patients through as their dementia progresses.
The service experiences of people with presenile dementia: A study of carers in one London Borough
Authors: Sperlinger David , Furst Maria 
Published: December 2004

AbstractFifteen carers of people with presenile dementia in the London Borough of Sutton were interviewed about their experiences of the services that had been provided to them. The carers were generally satisfied once they had been referred for specialist help and they would have liked more support and information around the time of diagnosis. When asked about what additional services were required, carers were particularly concerned about the lack of appropriate day care for their relative. Carers whose relative had been admitted to long‐term care reported finding the process of admission distressing. High levels of stress were found among all the carers. The importance of providing emotional support to this group of carers is emphasized.
Evaluating the effects of brief day hospital closure
Authors: Rolleston Margaret , Ball Christopher 
Published: December 2004

AbstractThe wellbeing of attenders of an old age psychiatry day hospital and their carers was assessed as the unit closed over a 2‐week period. Decline in the wellbeing of carers and attenders was seen with a regression to preclosure levels. The results suggest the importance of the day hospital to the patients and their carers. The problems of evaluation at short notice are discussed.
A pilot placebo‐controlled study of trazodone and buspirone in alzheimer's disease
Authors: Lawlor Brian A. , Radcliffe Jeanne , Molchan Susan E. , Martinez Rick A. , Hill James L. , Sunderland Trey 
Published: December 2004

AbstractThe pharmacological management of behavioural symptoms in Alzheimer's disease is limited by the dearth of effective agents in this area. The purpose of this study was to determine whether trazodone or buspirone are helpful in the treatment of behavioural disturbance in AD. Ten patients meeting NINCDS criteria for AD with behavioural complications were administered trazodone (up to 50 mg tid), buspirone (10 mg tid), and placeboin a 12‐week double‐blind, crossover design. Outcome measures were the Brief Psychiatric Rating Scale (BPRS), the Dementia Mood Assessment Scale (DMAS), and the Buschke Selective Reminding Task. The data were analysed by ANOVA. Compared to placebo, trazodone produced a small but significant reduction in BPRS and DMAS scores (p<0.05), indicating improvement in behaviour but no change in cognitive measures. In contrast, buspirone has no significant effect on either behavioural or cognitive measures compared to placebo. The results of this pilot study suggest a beneficial role for trazodone, but not buspirone, in the treatment of behavioural disturbance in AD. Further studies using a wider range of doses of trazodone in more behaviourally disturbed AD patients should now be initiated in an attempt to replicate and expand on this preliminary finding.