ISSN:0885-6230    

DOI:10.1002/gps.930070502

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThis article reports findings from a longitudinal survey of very elderly people living at home in London. The research aimed to identify social, psychological and physical characteristics associated with positive ageing and successful survival in the community in later life and its converse—negative ageing—as well as the associated policy implications. Associations with psychiatric morbidity, measured using the General Health Questionnaire, among sample members without cognitive impairment between the baseline interviews in 1987 and at follow‐up, two and a half years later in 1990, are reported. Twenty‐five per cent of survivors scored over the threshold of the GHQ in 1987 and 30% scored over the threshold in 1990. Half of those with a score over the threshold in 1990 also scored over the threshold in 1987. Hierarchical regression (using residualized change analysis) was used to estimate the effects of the independent variables on changes in psychiatric morbidity. The most significant predictor of psychiatric morbidity (GHQ score) in 1990 was baseline GHQ score, followed by health and functional status scores. Health and functional status were also the strongest predictors of baseline (1987) GHQ scores. The uniqueness of the study lies in the collection of follow‐up data on a sample of very elderly people, given that most surveys are corss‐sectional and contain too few people aged 85+ to merit separate analysis. It contributes to the small body of literature on outcome of depression. The lack of consistent associations with recovery from psychiatric morbidity in the literature enhances the importance of studies aiming to identify factors associated with differe

ISSN:0885-6230    

DOI:10.1002/gps.930070503

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractInaccuracy in the diagnosis of the dementia syndrome is widely reported. In a postal survey which asked hospital specialists about their use of diagnostic criteria and explored their knowledge of the aetiology of the syndrome, clear differences between research findings and clinical practice emerged. Clinicians are unlikely to use research diagnostic criteria and about half of the respondents consider the results of investigations to be essential in the diagnosis of the dementia syndrome. The frequency of contact with new patients with the dementia syndrome influenced some aspects of knowledge of its aetiology.

ISSN:0885-6230    

DOI:10.1002/gps.930070504

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractMortality rates following patient admission and patient death were measured in the surviving spouses of a sample of dementia patients admitted to a psychogeriatric unit between 1971 and 1986. The vital status of 85% of spouses was confirmed, and the ratio of observed to expected deaths (SMR) was calculated using regional and national mortality statistics.Spouse mortality following first admission to hospital was significantly lower than expected (p<0.006), and spouse deaths following bereavement were significantly fewer than expected (p<0.026). When male and female spouse mortality rates were compared, no significant differences were found, but there was a trend towards lower mortality in female spouses.The results give no support to the theory that hospital admission often follows a breakdown in the health of a caring spouse. Previous studies have shown an increase in mortality following conjugal bereavement, but the spouses of dementia patients were relative survivors and outlived their married and widowed counterparts in the general population. The possible relationships between dementia, anticipatory grief, and the impact of bereavement on the health of the surviving spouse are discussed.

ISSN:0885-6230    

DOI:10.1002/gps.930070505

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe case notes of 37 patients with neuropathologically confirmed Alzheimer's disease were studied for non‐cognitive psychiatric features occurring during the course of the illness. Four (11%) exhibited delusions, five (14%) had visual hallucinations and one (3%) had auditory hallucinations. Two (6%) developed a misidentification syndrome, five (14%) developed non‐delusional paranoid thinking and six (16%) had significant depressive symptoms with two (5%) developing major depression. Possible explanations for the wide variation in reported rates of psychotic symptoms in Alzheimer's disease in the literature are discus

ISSN:0885-6230    

DOI:10.1002/gps.930070506

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe structure and function of a small psychogeriatric community outreach team is outlined, together with the results of intervention in 100 consecutive cases. Patients in residential or nursing home care were rated for level of behavioural disturbance at entry to the study and after three months. Patients with dementia and psychotic disorders showed clinically and statistically significant improvement, whereas the improvement of patients with major depression was not statistically significant. The usefulness of the outreach service was evaluated independently by carers and by referring agents. Eighty per cent of carers and 87% of referring agents rated the service as useful or very useful. It was concluded that a small outreach team (comprising the equivalent of only six full‐time staff) is an effective and acceptable supplement to the overall care of psychogeriatric patient

ISSN:0885-6230    

DOI:10.1002/gps.930070507

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractCognitively impaired or mentally ill older individuals placed in community accommodation specifically for the elderly mentally infirm (EMI) may not always be viewed as successfully placed by residence staff. This sometimes necessitates a move to alternative care. This article examines several factors that may influence care staff views about current success of residents' placement and finds that affective behavioural factors correlate more strongly with this than either cognitive function as measured by Mini Mental State or behaviour reflected in Crichton Rating Scale scores.

ISSN:0885-6230    

DOI:10.1002/gps.930070508

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractRecent momentum for increased provision of residential respite services for people with dementia is not supported by empirical data. Yet the literature is replete with anecdotal reports indicating the efficacy of residential respite. This discrepancy may have resulted from methodological flaws in the research, lack of awareness by consumers and health professionals and great diversity in the reasons for, and among the recipients of, respite. Theprescriptionof respite care will need to be more specific and rigorous—matching the correct dose of respite care to the needs of recipients and caregivers—for future research to demonstrate its effic

ISSN:0885-6230    

DOI:10.1002/gps.930070509

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe prevalence of depression in 80 well‐diagnosed demented patients was examined using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) based on information from patients, caregivers and professionals. The overall prevalence of DSM‐III‐R major depressive illness was 5%, but the identification of depressed patients and the prevalence rate varied with the source of information used. The symptom profiles of the patients were examined in more detail. The significance of these findings and the use of operational diagnostic criteria in the investigation of coexistent depression and dementia are disc

ISSN:0885-6230    

DOI:10.1002/gps.930070510

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractA four‐week double‐blind study of zuclopenthixol and thioridazine in 64 elderly patients presenting with hostility or restlessness has been carried out in five Finnish mental hospitals. The ages of the patients in the two groups ranged from 64 to 97 years. The initial daily dose was 2–6 mg zuclopenthixol or 20–60 mg thioridazine. In week 4 the mean daily dose was 6.8 mg zuclopenthixol and 62 mg thioridazine. AFter one week of treatment the severity of illness was reduced significantly in the zuclopenthixol group and in both groups after two and four weeks. The key symptom hostility showed significant improvement in both treatment groups after only one week of treatment. The other key symptom restlessness was also significantly improved in both groups. The only significant difference between the groups was a better effect on sleep disturbance with zuclopenthixol. Few side‐effects were recorded in either group, and no serious effects on cardiovascular function were found. The study indicates that both zuclopenthixol and thioridazine are effective drugs in the treatment of elderly patients with symptoms such as hostility, aggressiveness and res

ISSN:0885-6230    

DOI:10.1002/gps.930070511

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY