摘要:

AbstractThe importance of economic considerations in determining the quantity and quality of services for people with dementia is beyond dispute. As the pressure on the resources available for health and social care increases, the need to mount a strong case for adequate resources for dementia‐related services has become more pressing. The article reviews available evidence under three headings: the impact of dementia on national economies; its impact on individuals and their carers; and the costs and benefits of different models of service provision. It is concluded that there is evidence for the inadequacy of resources currently available; those resources could in many instances be better targeted; but there remain substantial gaps in our knowledge of the costs and benefits of different services and the likely long‐term impact of increases in the numbers of people with demen

ISSN:0885-6230    

DOI:10.1002/gps.930080502

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThirty‐six cases of patients with clinically diagnosed Alzheimer's disease (CDAD) were identified from the dementia clinic of the Burke Rehabilitation Center. Controls were identified from the rehabilitative units of the same facility. Controls were matched for age within 5 years, sex, race, marital status, status at time of surrogate interview (case alive or dead), and the absence of dementia.Birth in an urban versus a rural environment (OR = 16), childhood in an urban versus a rural environment (OR = 9.5), and adult life in an urban versus a rural environment (OR = 16) were associated with an increased risk to develop CDAD. The daily or weekly use of beef/pork (OR = 4) and saccharin (OR = 2.25) were associated with an increased risk to develop CDAD as was the ownership of a pet rabbit (OR = 2). Further, a history of other cancers (OR = 3) in cases with CDAD was associated with an increased risk to develop CDAD. Type A personality characteristics were found to be associated with an increased risk (‘ate fast’ (OR = 3.5)), ‘not relaxed and easy‐going’ (OR = 2.25), ‘always rushed’ (OR = 2.00) to develop CDAD as was a history of depression (OR = 2). Due to the small sample size, statistically meaningful confidence intervals could not be calculated and our results must be confirmed in larger samples of cas

ISSN:0885-6230    

DOI:10.1002/gps.930080503

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThe case‐finding performances of three operationalized systems for identifying phobic disorder in the elderly (Geriatric Mental State (A) (GMSA)/AGECAT; DSM‐III; Phobic Disorders screen (PDS)) were compared in a sample of clients of a local authority community care service. There was considerable variation in the 1‐month prevalence rates (3.6%‐25.6%) according to the different criteria, and the concordances between various levels of case definition in the diagnostic systems demonstrated that this variation was due principally to different hierarchical diagnostic rules and severity criteria, including differing assumptions and expectations as to what constitutes a phobic disorder in

ISSN:0885-6230    

DOI:10.1002/gps.930080504

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThe efficacy of an intervention programme designed to support performance in activities of daily living was investigated in four patients with dementia at different levels of severity of impairment. Important features of the programme included that (a) task conditions should be highly supportive, (b) the importance of episodic and semantic memory skills for successful performance should be minimized, (c) an acceptable performance level should be possible to achieve using skills that are relatively well preserved in the disease, and (d) factors related to patients' motivation and habits should be taken into account. Performance gains were evaluated using the Assessment of Motor and Process Skills instrument. Results showed intervention‐related gains in three patients. One of these patients maintained performance gains when environmental guidance (eg signs) was withdrawn, whereas the other two required environmental guidance in order to exhibit gains. The overall pattern of results suggests that this form of intervention related to everyday functioning in dementia is worthy of further empirical attentio

ISSN:0885-6230    

DOI:10.1002/gps.930080505

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThe relationship between age and the outcome of ECT was prospectively studied in 78 patients with DSM‐III‐R major depression with melancholia or psychosis. Sixty‐eight patients were similarly evaluated for change in cognitive performance before and after treatment. Strongly positive correlations between increasing age, response to ECT and improved cognitive function were demonstrated and emphasize that ECT remains an important treatment for depression in old age, where the greatest benefits may be

ISSN:0885-6230    

DOI:10.1002/gps.930080506

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThis article describes a study of staff activity in six nursing homes for the elderly mentally ill. Three homes formed a Department of Health Special Medical Development (SMD), were highly resourced in terms of staff, and aimed to provide a good care environment and a high quality of life for the residents. The other three homes were included for comparison. The extra resources available within the SMD homes were largely used for routine care, such as resident hygiene, rather than 'positive', life ‐ enhancing care, such as social interaction and group activities. The failure to deliver positive care in line with increases in staff numbers cannot easily be explained. However, the indication is that it is not a result of substituting untrained for trained staff, but is rather related to the way staff resources are deploye

ISSN:0885-6230    

DOI:10.1002/gps.930080507

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractIdeomotor apraxia (IMA) and ideational apraxia (IA) were studied in 32 Alzheimer's disease (AD) patients and in 30 non‐demented elderly controls using a standardized apraxia battery. AD patients performed significantly worse than controls on all apraxia tests, and were more impaired when pantomiming movements than when imitating movements. IMA and IA scores correlated with severity of dementia as measured by the Mini‐Mental State Examination. Analysis of individual performances revealed dissociated apraxic disorders in four patients, which may be interpreted as a manifestation of focal damage to left hemisphere cortical systems involved in praxis. Furthermore, these results suggest a greater ideational than ideomotor defect in apraxic AD patie

ISSN:0885-6230    

DOI:10.1002/gps.930080508

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThe relationship between social and life conditions on the one hand and the presence of depression on the other was analysed in a population of institutionalized elderly subjects. The influence of health status on psychological condition and the presence of endocrinological changes in hormones associated with chronic stress were investigated in depressed elderly people. One hundred and thirty‐seven elderly people (mean age 82.4 ± 7.7) were studied and 60 of them underwent a thorough psychiatric examination. The overall prevalence of depression‐not previously diagnosed in all but one patient—was 76.6%; 23.3% were severely depressed. Neither gender nor the presence of organic disease differentiated the depressed from the non‐depressed. The only two life and social variables associated with depression among the many items analysed were the length of institutionalization and the period of retirement. It was observed that a higher cortisol level in the severely depressed group showed a positive correlation between plasma (and urine) cortisol level and Hamilton Rating Scale for Depression (HRSD) score. A relationship between immunological impairment and depression in old age has been reported elsewhere; it is suggested that these findings could be partly mediated by the observed endocrinological

ISSN:0885-6230    

DOI:10.1002/gps.930080509

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractIn 1985 a random sample of 612 elderly Chinese aged 65 and over living in the community in Sigapore was interviewed using the GMS‐AGECAT package. The survey identified 35 cases and 28 subcases of depressive disorder. Five years later only 31 cases could be traced; in this subsample 10 were still depressed (32.3%), eight had recovered (25.8%), five were categorized as subcases of depression (16.1%), two were diagnosed as anxiety disorder (6.5%), one case was diagnosed as having dementia (3.2%) and five had died (16.1%). Only 25 subcases from the initial study could be traced; of these, three had developed depression (12.0%), 15 had recovered (60.0%), four remained as subcases (16.0%) and three had died (12.0%

ISSN:0885-6230    

DOI:10.1002/gps.930080510

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractA pair of monozygotic twins who are concordant for dementia of frontal lobe type are discussed. This is believed to be the first case report of twins with this type of dementia. The salient features of dementia of frontal lobe type are also discussed.

ISSN:0885-6230    

DOI:10.1002/gps.930080511

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY