ISSN:0885-6230    

DOI:10.1002/gps.930071202

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:0885-6230    

DOI:10.1002/gps.930071203

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractLittle is known about the prevalence of psychiatric illness in elderly people with mental handicaps. Behaviour disorders occur less often in the elderly compared to younger groups, but which other illnesses they are vulnerable to or protected from is unknown. Associated characteristics are not clear, not is the interrelationship with social factors. Issues of treatment have not been addressed. Postmortem studies in Down's syndrome suggest almost 100% of individuals over 40 to have neuropathological changes of Alzheimer's disease, but this is probably an overestimation of the true prevalence. Attempts to link neuropathological findings with clinical findings have been disappointing; clinical dementia is elusive. When a decline in skills has been elicited, studies have often overlooked the differential diagnosis, making a presumptive diagnosis of Alzheimer's disease. To date there has been no comprehensive prospective study with neuropathological correlates in the field of Down's syndrome and dementia. People with mental handicaps are living longer, and hence the elderly are emerging as a new group in our society. The impact that this will have on services cannot be predicted and planning of provisions cannot be made until there is more knowledge about this group of individuals.

ISSN:0885-6230    

DOI:10.1002/gps.930071204

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe objective of this study was to determine if non‐psychiatric morbidity increases with age in a group of low‐income psychiatric outpatients. Data on demographics, presenting complaints, DSM‐III diagnoses and use of psychiatric services were collected on all individuals(N = 382)admitted to a psychiatric outpatient clinic serving low‐income population. Non‐psychiatric morbidity was identified on the basis of medical history, physical examination, and laboratory investigations. Bivariate analyses were done to determine the significance of the associations of comorbidity with other variables. A logistic regression was done using the presence or absence of comorbidity as the dependent variable. Age was the only variable which was significantly predictive of comorbidity. Additional resources should be allocated for the diagnosis and treatment of comorbidity among low‐inc

ISSN:0885-6230    

DOI:10.1002/gps.930071205

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractSeventy‐eight consecutive patients who attended a ‘memory clinic’ underwent a standardized clinical examination including extensive laboratory tests and cranial computed tomography (CT). This brief report evaluates the contribution of quantitative CT scan analysis to the differential diagnosis of early dementia syndromes. Vascular changes were readily identified in 13 patients with a clinical history and findings compatible with vascular dementia. Enlargement of the anterior and Sylvian fissures and of the third and lateral ventricles was significantly more severe in a group of 29 patients diagnosed as Alzheimer's disease than in 36 ‘memory complainers’ with milder cognitive impairment or in 10 age‐matched non‐demented controls. Quantitative CT scan analysis alone permitted a correct diagnositc distinction between ‘memory complainers’ and patients with Alzheimer's disease in 83% of the cases, but led to an only modest improvement of the correct discrimination achieved by cognitive testing. Our results indicate that CT scans may aid the differentiation of ealry dem

ISSN:0885-6230    

DOI:10.1002/gps.930071206

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractIn a catchment area survey of general practitioners regarding their use of the psychogeriatric domiciliary service, a comparison is made between those doctors with a high or low use of such visits in the care of their elderly patients. General practitioners with a high use of the service tended to be more satisfied with the service and more prepared to attend domiciliary visits. The high users were also more likely to consider the patient's physical disability as an important factor in their decision to request a visit in preference to another method of assessment. However, high users were less likely to have had previous psychiatric training and more likely to feel susceptible to pressure from relatives. Although in some ways high users seemed to be using the service more appropriately, psychiatric training may be important in helping the general practitioner to cope with elderly patients.

ISSN:0885-6230    

DOI:10.1002/gps.930071207

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractNight sleep symptoms and their relationship to a number of psychic, somatic and social variables were investigated in 453 elderly subjects living in the community. Multivariate statistics indicated that: (a) higher levels of somatization and anxiety were independently associated with worse quality of sleep; (b) depression was not independently associated with poor sleep quality, and association in univariate analysis was explained by higher levels of somatization; (c) sexual interest, which may be an indicator of active sexual life, was associated with better sleep quality both in elderly men and women; (d) waking up frequently in the night showed a correlation pattern with psychic, social and somatic variables different from the other sleep symptoms, suggesting a different cause.

ISSN:0885-6230    

DOI:10.1002/gps.930071208

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe presence of depression was evaluated in a cross‐section of 50 outpatients with dementia using the self‐rated Geriatric Depression Scale and the clinician‐rated Cornell Depression Scale. Impaired insight, as manifested by unawareness of dementia, correlated with dementia severity and discriminated a group of patients in whom the self‐rated scale failed to show evidence of depression. Discrepancy between the two types of scales occurred among mildly as well as moderately demented patients when insight was impaired. Recognition of this discrepancy suggests that reliance on self‐ratings may underestimate the presence and degree of depression among patients with

ISSN:0885-6230    

DOI:10.1002/gps.930071209

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractA 16‐week open‐label trial of high‐dose oxiracetam (up to 3200 mg per day), was not clinically effective overall in treating a small cohort of patients with mild‐moderate dementia of the Alzheimer's type (DAT). However, one of six patients did demonstrate evidence of progressive clinical improvement followed by relapse after discontinuation of medication. Resumption of treatment with oxiracetam after a 6‐month interval was associated with a similar pattern of improvement on neuropsychological testing and enhanced social functioning which was sustained during an additional 5 years of treatment. Following death due to unrelated causes, brain histopathologic findings were consistent with late‐stage DAT despite the patient's sustained clinical improvement while under treatment with

ISSN:0885-6230    

DOI:10.1002/gps.930071210

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThis is a case report of an elderly hypertensive patient with mania relatively unresponsive to neuroleptics, whose illness was effectively controlled with verapamil in both the acute and the maintenance phase of treatment.

ISSN:0885-6230    

DOI:10.1002/gps.930071211

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY