ISSN:0885-6230    

DOI:10.1002/gps.930091002

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractAn 8‐year longitudinal study of elderly people has provided data concerning age‐associated impairment (AAMI). In 1985 a random sample of 146 persons aged 65 years or more, living in their own homes, were assessed using the Guild Memory Test the Mini–Mental State Examination (MMSE) and other ratings. After excluding 21% of the sample because they scored less than 24 on the MMSE, and another 34% who fulfilled other exclusion criteria, some 48% of the remainder (22% of the total sample) clearly fulfilled NIMH criteria for AAMI and a further 36% (16% of the total sample) were recorded as forgetful. The NIMH criteria are appropriate for certain research purposes but not in assessing prevalence of memory disorders. Follow–up interviews were conducted after 2, 4, 6 and 8 years. The mortality rate and development of dementia among those fulfilling criteria for AAMI appeared similar to the other non‐demented groups of subjects; the mortality rate of those with MMSE scores below 24 was significantly higher. Guild test results at 2‐yearly intervals showed considerable changes; half of those scoring least well who were retested showed

ISSN:0885-6230    

DOI:10.1002/gps.930091003

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe Liverpool Continuing Health in the Community Study has followed up 1070 elderly community subjects over 6 years. In the first year 123 subjects had case‐level depression. Three years later 49 (39.8%) of the previously depressed were recovered, 33 (26.8%) were depressed, 16 (13%) were not available for interview and 25 (20.3%) were dead. This study looks at factors associated with the 3‐year outcome of patients who were depressed at year 0. Two outcome groups that were compared were a recovered depression group and a recurrent/persistent depression group. The factors that were significantly associated with a recurrence of depression (or persistent depression) at year 3 were bereavement of a close figure in the 6 months before interview, loneliness and life dissatisfaction at year 3. A variety of traditional risk factors for depression (including age, marital status, physical ill‐health and incapacity) failed to attain significance in predicting recurrent or persistent depression. When combined, both recovered and recurrently depressed groups at year 3 had significantly higher levels of pain and a higher number of serious upsets in the past 6 months and 6 weeks compared to a compared to a control group. The depressed at year 0 were more likely to have entered more dependent forms of accommodation by y

ISSN:0885-6230    

DOI:10.1002/gps.930091004

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe MEAMS (Middlesex Elderly Assessment of Mental State) is a relatively new scale specifically developed to detect intellectual impairment secondary to organic brain dysfunction in the elderly. In this study the MEAMS was compared with the MMSE (Mini‐Mental State Examination), a widely known and commonly used brief cognitive rating scale, in a group of 60 elderly acute psychiatric inpatients. Scores on both scales were highly correlated. However, the MEAMS was shown to be more sensitive in the detection of mild cognitive impairment, and was more sensitive to the presence of focal brain lesions than the MMSE. In the second part of the study, a further 25 inpatients were assessed using both scales by six junior and staff‐grade doctors, who then rated the scales according to various criteria. Despite taking slightly longer to administer, the MEAMS was rated superior overall by the medical staff. It is suggested that the MEAMS is a sensitive instrument acceptable to both patients and staff, and is suitable for routine use in an old age psychiatric sett

ISSN:0885-6230    

DOI:10.1002/gps.930091005

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe Telephone Interview for Cognitive Status (TICS) is an 11‐item screening test (maximum score=41 points) that was developed for the assessment of cognitive function in patients with Alzheimer's disease who are unwilling or unable to be examined in person. To investigate the 1‐month test‐retest reliablility and validity of the TICS in a stroke sample, we administered it twice by telephone to 36 stroke patients (age = 72.3 ± 8.9; education = 9.7 ± 4.7) and 36 stroke‐free non‐demented control subjects (age = 71.8 ± 6.8; education = 13.1 ± 4.1). Dementia was diagnosed in six stroke patients based on neuropsychological and functional examinations performed during an outpatient visit and the Mini‐Mental State Examination (MMSE) was also given. Multiple regression analyses determined that stroke status was significantly related to performance on the TICS (β= −0.26,p= 0.006), while adjusting for demographic variables. Among stroke patients, test‐retest reliability was excellent (r = 0.90,p<0.001) and performance was significantly correlated with MMSE score (r = 0.86,p<0.001). A TICS cutoff score<25 best distinguished between demented and non‐demented patients; sensitivity (1.00) and specificity (0.83) were excellent and comparable to the sensitivity (0.83) and specificity (0.87) of the MMSE, with dementia defined as a score<24/30. We conclude that the TICS is a reliable mental status test that can provide accurate information regarding cognitive function in stroke patients who cannot

ISSN:0885-6230    

DOI:10.1002/gps.930091006

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractA retrospective casenote review was performed on all patients over 65 years of age in one health district who were detained under the Mental Health Act 1983 during the first 6 years of its operation. There were 132 episodes of detention affecting 120 patients. Fifty‐three percent were for organic illness and 47% for functional illness. The organically ill were detained most commonly because the carer was no longer able to cope or, for those living alone, because of self‐neglect. The functionally ill were most commonly detained in the interests of their health only. The majority (52/64) of patients with dementia were not discharged to their previous address after being detained, most of these (29/64) being discharged to residential care. Twenty‐seven percent of the whole sample died within a year of being detained, a rate higher than that in the general population. Only nine tribunals were held in the study p

ISSN:0885-6230    

DOI:10.1002/gps.930091007

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractPart 1 describes the case of a 74‐year‐old woman who experienced a worsening of her psychiatric condition shortly after commencing fluoxetine and was found to have a low serum sodium level. The clinical features of hyponatraemia and its causes are reviewed. Part 2 reviews the reports of hyponatraemia and the selective serotonin reuptake inhibitors (SSRIs) and considers the variation in reports between the different SSRIs. Measurement of a patient's electrolytes is recommended if there is a rapid decline in mental state having started on an S

ISSN:0885-6230    

DOI:10.1002/gps.930091008

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractA consensus conference on the topic of clinical drug trials in cognitive disorders of the elderly was held in Marseille on January 28–29, 1993. At the end of this conference, several recommendations were made. Drugs used in trials must be chosen according to solid neurobiological evidence. Clinical trials profoundly alter the relations between the doctor, the patient and his family and this aspect must be taken into account. Clinical trials should be designed to obtain meaningful and useful data in the domains of pharmacology and epidemiology. Patient selection criteria must be defined with strict attention to the nosology of syndromes causing cognitive disorders in the elderly. Objective evaluation tests able to detect subtle drug effects must be carefully chosen according to the requirements of each trial. Whenever possible, laboratory tests should be used in addition to clinical data. The ethical implications of clinical trials in demented patients require special adaptation to satisfy legal requirement

ISSN:0885-6230    

DOI:10.1002/gps.930091009

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractA retrospective audit of 209 consecutive general practitioner referrals to an old age psychiatry service was performed to examine the quality of information available at the time of assessment, the diagnostic agreement and the differences between letter and telephone referrals. The information in telephone referrals was less complete, particularly for details of medical history, physical examination and investigations. However, diagnostic agreement was better for telephone than letter referrals. Overall use of cognitive function testing was low and was associated with misdiagnosis between functional and organic illness. In addition, a substantial number of cases of depressive illness were misdiagnosed as anxiety disorders or other functional illnesses. Our study suggests the need for clearer guidelines for referral procedures and continuing efforts to improve communication between general practitioners and old age psychiatrists.

ISSN:0885-6230    

DOI:10.1002/gps.930091010

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractIn this pilot study we sought to find brief, usable, reliable and valid measures of outcome from a variety of viewpoints for older adults admitted to hospital with depression or dementia. We examined patients', carers', primary nurses', consultants' and general practitioners' perceptions of outcome using a variety of measures. For the depressed patients we used nurse‐rated change on the Montgomery Asberg Depression Rating Scale (MADRS) as the main outcome measure. Adequate data for analysis were collected on 24 depressed and 16 demented patients. In the depressed group there was a highly significant improvement on the MADRS. Factor analysis of the scales used produced four factors. The MADRS and the depression subscale of the Hospital Anxiety Depression (HAD‐D) were strongly weighted on the first factor, the GPs' linear analogue scale on the second, the Selfcare‐D (and the HAD‐D) on the third and the anxiety subscale of the HAD (HAD‐A) on the fourth. The HAD, which is brief and easy to use, and the GPs' linear analogue are suggested for further evaluation as routine outcome measures for depressed elderly people. For demented patients carers' rating of resolution of perceived problems is tentatively suggested for further inve

ISSN:0885-6230    

DOI:10.1002/gps.930091011

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY