ISSN:0885-6230    

DOI:10.1002/gps.930070602

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe influence of marital status on ‘hospital survival time’ (the interval between first admission and death) was investigated in a controlled study of hospital dementia patients. There was no evidence of a significant relationship between marital status and hospital survival time after controlling for age and sex differences. The presence of a supporting spouse did not apparently shorten hospital survival time or postpone admission. Mortality following admission was analysed during the period of the study 1971–86. The probability of death during the six months following first admission was 45% for males and 32% for female patients (patients of all marital status combined), and the respective 12‐month figures were 59% and 44%. The median hospital survival time for married male and female patients was 0.6 years and 1.8 years, which suggests that first admission to hospital occurred as a late event. It follows that additional community support to families may not be effective in further reducing the demand for hospital care during the terminal stages of d

ISSN:0885-6230    

DOI:10.1002/gps.930070603

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractAlthough psychiatric illnesses are common occurrences in institutions taking care of the elderly, admission is seldom preceded by a mental health evaluation and only rarely are there provisions for ongoing psychiatric care. Screening a population for specific psychiatric disorders is traditionally carried out by lay interviewers. In field studies organized under the Epidemiological Catchment Area Program of the National Institute of Mental Health they were specially trained to complete the Diagnostic Interview Schedule (DIS) (Munsonet al., 1985; Robinset al., 1985). An initial examination carried out by a trained psychiatrist can, however, also be regarded as a screen for the detection of the presence or absence of a psychiatric disorder, and defining a ‘case’ (Leightonet al., 1966). It represents the first step in the evaluation. The establishment of a specific diagnostic label, though at times possible as a result of one examination, is more usually determined at the second, third or fourth step after obtaining additional information from relatives or caregivers, and assessing the results of neuropsychological and biological tests. CAPER (Clinical Assessment of Psychopathology among Elderly Residents) was developed to provide in a semistructured format such a typical initial examination of elderly residents of long‐term institutions. It is designed to represent the first step in a comprehensive evaluation, can be completed in 15–20 minutes and generates clinically useful information. CAPER allows the examiner to draw conclusions commonly encountered in everyday practice and gives a choice between (1) no psychopathology, (2) definite psychopathology and (3) suspected psychopathology. A great deal of demographic data are also accumulated and entered into a specifically designed multi purpose computer program. The program can be used for epidemiological studies to determine the prevalence of specific disorders in different populations, but also has applications in correlating the findings of an initial clinical examination with the results of neuropsychologica

ISSN:0885-6230    

DOI:10.1002/gps.930070604

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractTen elderly patients were evaluated serially for interictal cognitive changes during the course of ECT using the Mini Mental State Exam (MMSE) and a modification of the Digit Symbol Substitution task (M‐DSS), an assessment of attention that measures the speed of mental processing. Performance decrease on the M‐DSS and MMSE correlated with both the number of seizures and cumulative seizure duration. The M‐DSS correlated with the MMSE items of ‘orientation’ and ‘attention’, but not with the ‘recall’ item, suggesting that the interictal memory and attentional changes induced by ECT may occur independently. For most patients, the serial performance on both the MMSE and M‐DSS decreased significantly during the course of ECT; however, the increase in the M‐DSS (indicating a performance decrement) was greater than 100%, compared to a decrease in MMSE score of less than 10%. These data are preliminary and replication with more patients and extension of the assessment for several weeks following cessation o

ISSN:0885-6230    

DOI:10.1002/gps.930070605

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractFourteen patients aged 66–87 years are described, in whom major psychiatric problems dominated the presentation of intracranial tumour. Six had initially been referred to psychogeriatricians and eight to geriatricians. All showed intellectual failure, developing over a few weeks or months, with failure of self‐care, and a variety of disturbances of behaviour. Four had undoubted and two possible seizures. Their mental state was described as facile, or slow, with relatively unimpaired memory when it could be tested. Four were inaccessible or mute. Abnormal neurological signs were absent in two, but included unilateral or bilateral hypertonia and hyperreflexia in most; the plantar responses were flexor in seven, equivocal in three, and extensor on one or both sides in four. Computed tomographic (CT) scans shows frontal or bifrontal tumours in 13, and one occipital lobe tumour. The corpus callosum was involved in eight. Ten tumours were considered to be high‐grade astrocytomas (proven by biopsy in three and autopsy in one); one patient had bifrontal metastatic tumours, and three had meningiomas, all of them successfully resected. Clinical diagnosis was difficult, but a CT scan is indicated in all patients with a short history of intellectual fa

ISSN:0885-6230    

DOI:10.1002/gps.930070606

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe effect of backward masking with illumination of all fields or with a checkerboard pattern, respectively, on the recognition of pattern + or T was measured on four groups of subjects: 21 presenile onset DAT patients, 16 patients with a questionable vascular dementia of the same age (CVD group), 15 age‐matched control subjects (EC group) and 16 younger control subjects (YC group, mean age 22 years). The pattern stimulus had a duration of 20 ms and was followed by the masking stimulus pattern (20 ms duration) with increasing intervals in steps of 5 ms. The mean recognition threshold (RT) for each of the four possible pattern–mask combinations was measured in five trials. The RTs decreased within the five trials in all groups. DAT patients and CVD patients adapted with different speeds during the five trials. We found a small significant RT difference between elder and younger control subjects, whereas patients had increased RTs in the first trial and differences in the four variants in the further trials compared with age‐matched controls. The test contributes to a set of data for diagnosis and differential diagnosis in the early stages of presenile dem

ISSN:0885-6230    

DOI:10.1002/gps.930070607

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractVisuospatial memory was studied in patients suffering from senile dementia of the Alzheimer type (SDAT). They had been allocated into one of two groups depending on the severity of their disorder (mild or moderate), and a control group of healthy elderly subjects was included. Three different microcomputer‐controlled tasks were used. The spatial span task was able to distinguish between the two SDAT groups. Both groups were impaired, relative to control, on spatial recognition. The deficit in spatial working memory was also equivalent in the mild and moderate groups and was accompanied by evidence of an intact strategic approach to the task. The normal positive relationship between spatial memory performance and strategy was in fact reversed in the SDAT groups, suggesting a pure spatial memory deficit. These results show that spatial memory processes are impaired in the early stages of SDAT and get worse as the disease progresses. They also suggest that the neuroanatomical foci of the deficits may be predominantly in posterior cortical regions (including hippocampus), rather than the frontal corte

ISSN:0885-6230    

DOI:10.1002/gps.930070608

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe Organic Brain Syndrome scale (OBS) of the Brief Assessment Scale (BAS) was administered to 1202 elderly subjects in London, Mannheim, Sydney and Melbourne. Subjects' knowledge of current and last national leaders was assessed, and two methods of scoring the OBS were compared. Taking into account the degree of cognitive impairment found using seven items of the OBS were compared. Taking into account the degree of cognitive impairment found using seven items of the OBS other than the national leader item, knowledge of current leader was much more consistent across countries than was knowledge of last leader. When subjects were allocated an error point for failing to know either current or last leader, dementia prevalence measured by the OBS was consistently 5–6% less than that found when they were allocated an error point for failing to know both leaders. Future studies using the BAS should publish prevalence data for both scoring methods in order to permit comparison between studie

ISSN:0885-6230    

DOI:10.1002/gps.930070609

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThis article presents the results of the application of a computerized diagnostic method (HAS–AGECAT) to a standardized psychiatric History and Aetiology Schedule (HAS) designed for use with older people. In a community sample from Zaragoza good agreement (kappa = 0.76) was obtained between HAS–AGECAT and the interviewing psychiatrist. The discrepant cases are discussed in det

ISSN:0885-6230    

DOI:10.1002/gps.930070610

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractBehaviour problems, dependency levels and use of antipsychotic medication were assessed, using an audit approach, in 104 patients in a geriatric psychiatry continuing care unit. High levels of dependency and behaviour disturbance were found. 37.5% of the population were receiving regular antipsychotic medication. The severity of a cluster of four symptoms (diurnal restlessness, agitation, irritability and active aggression) tended to discriminate this group from those on no antipsychotics, though frequency of problems and total number of problems were also higher in the group on regular antipsychotics. Antidepressants were rarely used, though conversely there was only one case of ‘missed’ depression. Changes following the audit are described and recommendations for improved monitoring of medication use are m

ISSN:0885-6230    

DOI:10.1002/gps.930070611

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY