ISSN:0885-6230    

DOI:10.1002/gps.930091102

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractCognitive deficits occurring with major depression in the elderly are well recognized. However, cognitive differences in depressed patients with and without psychotic features have received little attention. Of 14 consecutively referred elderly patients with major depression, the eight patients with psychotic features had significantly more cognitive deficits on neuropsychological tests than the six patients with major depression without psychotic features. The differences in performance IQ were most remarkable, but the differences extended to verbal IQ subtests, word fluency and memory.

ISSN:0885-6230    

DOI:10.1002/gps.930091103

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe Medication Management (MM) Test is a new technique for measuring high‐level adaptive functioning in early dementia. Scoring is based on direct observation of the subject's performance on a structured task, simulating calculations and manipulations involved in the self‐administration of medications. The equipment is lightweight, small and portable. Procedures are brief and readily administered with little training. It is congruent with a general health inquiry and not threatening to the subject's self‐image. The sensitivies and specificities with respect to criterion diagnosis of dementia are as good as five widely used brief cognitive screens, and hold up well in early cases. The scores are not biased by gender, culture or setting; and are less biased by age and education than are conventional cognitive sc

ISSN:0885-6230    

DOI:10.1002/gps.930091104

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractA related article showed that five widely used screens for dementia predicted criterion diagnosis well with extreme scores, but misclassified many persons when screen scores were intermediate (borderzone). In this article, based on representative samples of community elders from the North Manhattan Aging Project, information on the subject's functioning was added to intermediate dementia screen scores and found to increase specificity, with sensitivity held constant. Informant reports on the subject's functioning predicted criterion diagnosis somewhat better than did the subject's self‐report of functionin

ISSN:0885-6230    

DOI:10.1002/gps.930091105

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe study used a diary‐based approach to examine the distribution of time of different professional staff in two community mental health teams for the elderly. It was possible to discriminate between two broad groups of staff, defined as core workers and extended role members of the teams based upon the range of responsibilities and patterns of time use. The latter group consisted of clinicians and psychologists. About three‐quarters of staff time was spent in client‐related activities, although there were differences between core and extended workers, the latter undertaking more service‐related activities. The similarity of patterns of time use by core workers and other community‐based workers is noted and the distinction between key workers and care managers is c

ISSN:0885-6230    

DOI:10.1002/gps.930091106

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe reported prevalence of Lewy body dementia (LBD) has varied from 12% to 20% in postmortem series. Such series may not be representative of the dementia population as a whole. We have attempted to determine the prevalence of LBD in patients referred to a district general hospital with a diagnosis of dementia. The case notes of a consecutive series of patients with a clinical diagnosis referred to the care of two consultants in old age psychiatry over a period of 1 year (N= 114) were analysed using a checklist incorporating the items of the criteria proposed by McKeith and by Byrne for thein vivodiagnosis of LBD. The analysis was repeated for the subgroup (N= 76) fulfilling ICD 10 criteria for Alzheimer's disease. The prevalence of LBD was 26.3% according to McKeith criteria, 7% according to Byrne probable and 16.6% according to Byrne possible criteria. There were, however, considerable disagreements between different criteria. The frequencies of individual clinical features within subjects fulfilling and not fulfilling LBD were reviewed. Logistic regression analysis revealed the main clinical features capable of differentiation between LBD and other dementias were: presence of visual or auditory hallucinations; extrapyramidal features or neuroleptic sensitivity syndrome; fluctuating pattern of clinical features over a long period of time (McKeith criteria); and presence of classical Parkinsonism with simulataneous or earlier onset of dementia (Byrne criteria). The results were essentially similar in the Alzheimer's disease subsample. A significant proportion of patients with dementia referred to an old age psychiatry service thus fulfilin vivocriteria for LBD. The variation in frequency of diagnosis of LBD by the different criteria suggests that these clinical criteria may need revising.

ISSN:0885-6230    

DOI:10.1002/gps.930091107

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe objective of this study was to examine the cerebral blood flow and the vasomotor function of CO2‐responsive intracerebral vessels in Alzheimer's disease. Patients met DSM‐III‐R criteria for dementia of Alzheimer type and had neither symptoms nor signs of cardiovascular or cerebrovascular disease. Blood flow velocities in both middle cerebral arteries (MCA) were recorded using transcranial Doppler sonography during hypercapnia, normocapnia and hypocapnia. Several psychometric tests were performed. Patients' age, disease duration and severity of dementia did not correlate with vasomotor reactivity. Exploratory analysis revealed that mean flow velocities under hypercapnia correlated with severity of dementia and with patient's age. This suggests that the disease process does not influence the autoregulative function of small resistance vessels as assessed by CO2challenge. However, the excess reduction of the highest flow velocities measured during maximal CO2stimulation indicates that the number of small capillaries are diminished, or alternatively that the diameters of these capillaries are reduced in Alzheimer's di

ISSN:0885-6230    

DOI:10.1002/gps.930091108

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractWe evaluated 14 patients with senile dementia of Alzheimer type (SDAT) and 15 age‐matched normal elderly controls using psychological test and computed tomography scans. The low‐density rate (LDR) was used as an index of brain atrophy. SDAT patients had significantly higher scores on the Hasegawa Dementia Scale (p<0.01) and significantly lower scores on the Bender Gestalt Test (p<0.01) than control subjects. The LDRs of the left and right hemispheres were significantly higher in the SDAT group than in the control group in all three slices investigated (p<0.05/6 = 0.0083). In SDAT patients, significant diagnosis by hemisphere interaction was observed in one slice (p<0.05), with higher LDR on the left than on the right (p<0.05/6 = 0.0083). Our findings suggest that cortical atrophy is predominant on the left side in patients with S

ISSN:0885-6230    

DOI:10.1002/gps.930091109

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe case of a middle‐aged woman, who presented with a 2‐year history of rapid cycling manic depressive illness, is described. As neuropsychological deficits emerged, the swings of mood subsided and her condition evolved into generalized anxiety with emotional lability. CT scan showed diffuse white matter changes in both cerebral hemisphe

ISSN:0885-6230    

DOI:10.1002/gps.930091110

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractPatients in long‐term care who scream continuously or continually cause considerable distress to other residents and staff. It is suggested that many such patients (whether demented or not) are depressed. However, antidepressants, ranquillizers and behavioural management techniques often fail to control the screaming. This article documents he affectiveness of electroconvulsive therapy (ECT) in the case of a 69‐year‐old woman with mild mental retardation, who had a past history and current evidence of depressive symptoms and who screamed for increasingly prolonged periods during the 4 months perior to ECT. It is recommended that use of ECT be considered in cases of elderly people who scream incessantly, especially if they might be depr

ISSN:0885-6230    

DOI:10.1002/gps.930091111

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY