摘要:

The relationship between severity of dementia and performance in four experimental tasks was studied in nine patients with Alzheimer's disease and nine age‐matched controls. The experimental tasks were developed in order to establish a direct measure of functional performance in common activities of daily living. In the Alzheimer's patients, significant but moderate positive associations were found between the Clinical Dementia Rating Scale (CDR), a comprehensive rating tool designed specifically for Alzheimer's disease, and performance on the experimental tasks. A significant correlation was also found between the results of the Short Portable Mental Status Questionnaire (SPMSQ), a less specific dementia assessment instrument, and the CDR but not between the SPMSQ and the performance measure. When compared to nine normal subjects matched for gender, age, and education, the cognitively impaired subjects required more assistance and time (P<.01) in completing the tasks. The findings support the conclusion that severity of dementia and performance on activities of daily living tasks are related but distinct concepts and should be measured separatel

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01776.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

A chart review of 658 psychiatric inpatients aged 65 years or older with a clinical diagnosis of schizophrenia revealed 32 patients (4.8%) with onset of symptoms after aged 45 who met DSM‐III criteria for schizophrenia (except age of onset). Clinical course and response to treatment revealed only25%to follow an unequivocally schizophrenic pattern. Almost 20% demonstrated substantial affective symptomatology, whereas 15.6% had a brief psychotic episode with full remission, and 40.6% showed signs of organic deterioration. These results suggest that diverse underlying pathologic processes may present initially as late onset schizophreniform illness. The presence of depressive symptoms and assaultive behavior on admission predicted good treatment response while sensory deficits and development of signs of organicity were associated with poor treatment respons

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01777.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

We studied the outcome of 101 patients with primary degenerative dementia. The patients were outpatients at the time of the initial evaluation, and all had family caregivers. There were substantial differences in mortality and institutionalization between the mild and advanced patients, as defined by scores on mental status examination. Similar differences in those two outcomes were also evident when the patients were stratified by scores on activities of daily living and disruptive behavior assessments. Thus, certain patient characteristics may be of value in predicting risk for institutionalization and death.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01778.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

A sample of several hundred elderly residents of Alameda County was recontacted after 5 years to determine the effects over time of different social support and demographic variables on health status.The follow‐up investigation demonstrated a strong relationship between respondents' social support resources in 1980 and their subsequent self‐rated health. Indeed, social contacts in 1980, together with age and financial need, enabled us to correctly “predict” respondents' subsequent health status in close to two‐thirds of the cases. As anticipated, however, the variable most strongly associated with self‐rated health in the earlier cross‐sectional study — illness of a mate during the preceding 6 months — disappeared as a predictor variable in the longitudinal study. This finding is in keeping with the literature on bereavement and other stressful life events which demonstrates that the health impact of such stressors is in most cases time‐limited.The study findings support earlier research demonstrating the important role of social support for health maintenance and disease prevention in the elderly. They further underscore the need for intervention strategies designed to strengthen the network resources of those elders at high risk f

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01779.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Finding an optimal source of controls is a major consideration in the design of case‐control studies. While hospital patients can provide a relatively economical and convenient source of controls, hospital controls may have diseases independently associated with the exposures being studied. Results of a recent case‐control study of multiple myeloma suggest that the problems of using hospital controls may be exacerbated in studies of diseases affecting the elderly, especially when considering risk factors which might be associated with chronic diseases. Apparently, the authors have encountered a modern analog of “Berkson's bias” in which cancer cases are referred to a tertiary care center for a single disease. On the other hand, noncancer patients who might serve as controls tend to be referred selectively if they have multiple diseases. This article reports some of the difficulties encountered in a case‐control study whose mean case age was 63.4 years and suggests that community controls selected by random digit dialing may be preferable to hospital controls for hypothesis‐generating case‐control studies of diseases i

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01780.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

This program was designed to encourage treatment of episodes of acute illness in skilled nursing facilities in order to avoid costly and potentially traumatic admission to hospital. It is part of the Monroe County Long Term Care Program, Inc, system of case management and Medicare and Medicaid waivers, and consists of financial incentives, paid by Medicare, to facilities and to responsible physicians to evaluate and care for acutely ill patients in the SNF's when medically safe and feasible. A retrospective evaluation using a physician assessment committee concluded that among the first 112 patients in the program, 76% were very probably saved hospitalization or at least an emergency room visit. Acute bacterial infection was the most common category of episode, occurring in46%of cases. Considerable savings to both Medicare and Medicaid were estimated to have resulted.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01781.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Exercise is known to preserve many physiological responses in the healthy elderly, yet those with physical impairments are often discouraged from exercising. The authors studied the effects of a closely supervised exercise program designed specifically for elders with health problems and functional limitations. Tests, selected for their relevance to clinical patient management, included the Self Evaluation of Life Function questionnaire, treadmill performance, and tests of autonomic nervous system and neuromotor functions. Ambulatory volunteers, aged 64 to 83 years, with noncardiac health problems, were randomly assigned to a control group (CG; n = 17) or a 16‐week exercise group (EG; 3 hr/wk, n = 18).Nine of the control and 13 of the exercise subjects completed the study. All EG dropouts were due to illness. EG attendance averaged 87%, and subjects trained at a heart rate (HR) of 103 $pL 5 beats/min (SD) (98% of prescription HR). Though EG test responses showed a tendency to improve, none reached statistical significance. This result was affected by the small number completing the study and the variability inherent in such a sample. Though these impaired elderly subjects enthusiastically and safely participated with high attendance and at an exercise intensity adequate to expect benefit, measurable training effects were not demonstrate

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01782.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01783.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

It has been recognized that AIDS can present initially as dementia without other neurological or clinical manifestations. In addition, HIV‐contaminated blood transfusions in the elderly seem to be underreported. Because of these findings, dementia in the elderly may be misdiagnosed as Alzheimer's disease or other causes of senile dementia. This paper reports on one patient who presented with a diagnosis of Alzheimer's disease and was later found to have AID

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01784.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb01785.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY