ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Depression affects 40%–50% of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors examined the association of Apolipoprotein-E (APO-E) genotype to symptoms of psychosis and depression in 501 patients diagnosed with probable (n=343) or possible (n=158) Alzheimer's disease (AD) according to NINCDS-ADRDA criteria. They observed the following APO-E genotypes: &epsis;2/&epsis;3 (n=19); &epsis;2/&epsis;4 (n=14); &epsis;3/&epsis;3 (n=228); &epsis;3/&epsis;4 (n=203); &epsis;4/&epsis;4 (n=37). In contrast to previous reports, the results did not indicate a relationship between either the &epsis;4 allele or the &epsis;2 allele and symptoms of mood disturbance in AD. However, an elevated risk for psychosis was shown, specifically, at the severe stage of cognitive impairment, among AD patients carrying the &epsis;4 allele, after effects of age, gender, education, and level of cognitive impairment were controlled.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Authors examined effects of depressive symptoms on after-discharge survival of hospitalized medically ill male veterans. Psychosocial and physical health evaluations were performed on a consecutive sample of 1,001 patients ages 20–39 (16%) and 65–102 years (84%). Subjects or surviving family members were later contacted by telephone, and Cox proportional-hazards regression modeled the effects of depressive symptoms on time-to-death, controlling for demographics and social, psychiatric, and physical health. Follow-up was obtained on all 1,001 patients (average observation time, 9 years), during which 667 patients died (67%). Patients with depressive symptoms were significantly less likely to survive. For every 1-point increase on the 12-item Brief Carroll Depression Rating Scale (BCDRS), the hazard of dying increased by 10% (P<0.0001). Age did not significantly affect the association between depressive symptoms and mortality. Depressive symptoms during acute hospitalization are a predictor of shortened survival.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors evaluated the safety, tolerability, and efficacy of risperidone in 103 elderly patients (mean age, 71 years) with schizophrenia (75%) or schizoaffective disorder (25%). Using the Extrapyramidal Symptoms Rating Scale (ESRS), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression (CGI) scale, they conducted a prospective, open-label, 12-week trial in 14 psychiatric centers in the United States. Patients' symptoms were assessed at baseline and over a 12-week period. At endpoint, ESRS scores were significantly reduced, as were PANSS total and subscale scores. There were no clinically significant changes in electrocardiograms, laboratory test results, or vital signs. Risperidone was well tolerated and efficacious in elderly patients with schizophrenia or schizoaffective disorder.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In a longitudinal study, the authors document the moves of dementia patients between different care settings, following up 103 individuals who had participated in an earlier study of the transition from home to institutional care. It was possible to document numerous moves between home, respite care, acute care hospital, and long-term care settings for these patients. The authors discuss the clinical implications of the many changes of residence for those suffering from dementia.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In geriatric patients with major depression (N=15), the authors compared response to treatment with nortriptyline as it relates to brain morphology assessed by computed tomography. There was a significant negative association between ventricle–brain ratio and response to nortriptyline (rs=−0.63; P=0.015).

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors explored cognitive functioning of a group of elderly subjects with depression. The group as a whole, and, in particular, the late-onset group (LOD), demonstrated cognitive impairment on the Mattis Dementia Rating Scale (MDRS). Subgroup differences were significant at P=0.004. This between-group difference was not seen when age and level of education were controlled. In the LOD group, 47.5% (vs. 31.5% of the early-onset group [P=0.025]), scored below the cutoff for dementia. Age-at-onset status in a logistic regression model predicted MDRS category, and treatment of the depression had little effect on cognition. Results support the hypothesis that late-life depression, particularly LOD, is associated with cognitive impairment that may represent early AD.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors evaluated the cognitive effects of acute challenges with the H2receptor-antagonist cimetidine in normal older volunteers. The study was a double-blind, placebo-controlled, crossover study of 12 volunteers, average age 71.25 years. Baseline assessment was followed by randomized administration of a placebo or ascending doses of cimetidine (400 mg, 800 mg, or 1,600 mg) in test sessions separated by 1 week. Cognitive performance was evaluated with a 1-hour battery of tests beginning 90 minutes after administration of a single dose of drug (or placebo). There were no significant cognitive decrements associated with cimetidine. Despite numerous case reports of cognitive toxicity, this study found no observable decrements in cognitive performance in a group of healthy elderly subjects; therefore, case reports in the literature may be reporting effects for patients with specific impairments or sensitivities.

ISSN:1064-7481    

出版商:OVID    

年代:1999

数据来源: OVID