ISSN:0251-5350    

DOI:10.1159/000109912

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This study documents the clinical features, incidence and prevalence of motor neuron disease (MND) in Hong Kong Chinese. Patients with MND who were alive between 1989 and 1992 were recruited by retrieval of medical records from the four major hospitals in Hong Kong, and by referral of neurologists, neurosurgeons and medical consultants. Mortality statistics was provided by the Census and Statistics Department. A total of 84 cases were identified with a male preponderance of 1.98:1. The average annual period incidence was 0.31/100,000 and the point prevalence on December 31,1992, was 0.95/100,000. The mean age at onset was 55.5 years (range 19–81) with a peak observed from 55 to 65 years. The clinical features are similar to other reported series of MND. The incidence and mortality of MND in Hong Kong are therefore lower than the worldwide figures of 2.0/100,000 and 1.5/ 100,000, respectivel

ISSN:0251-5350    

DOI:10.1159/000109913

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Standardization of diagnostic procedures for cognitive impairment in large epidemiologic surveys remains difficult. This paper reports results of diagnostic standardization in a subsample of 2,914 elderly (age 65 years+) Canadians from the Canadian Study of Health and Aging (CSHA; n = 10,263). The objectives were to measure the consistency of the CSHA diagnosis as a test of validity; to assess inter-rater reliability, and to assess the impact of neuropsychological data on the diagnosis of dementia. The CSHA clinical assessment included a nurse''s examination, Modified Mini-Mental Status (3MS) exam and Cambridge Mental Disorders Examination, neuropsychological tests, medical history and examination, and laboratory investigations. A final diagnosis was reached in a consensus conference which incorporated preliminary diagnoses from both physicians and neuropsychologists. Computer algorithms, which were developed to check consistency between the clinical observations and the final diagnosis, demonstrated 98% concordance with DSM-III-R criteria for dementia and 92% with NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer''s Disease and Related Disorders Association) criteria for probable Alzheimer''s disease. Inter-rater agreement was high: Κ= 0.81 for dementia/no dementia; K= 0.74 for normal/cognitive impairment, not dementia/ dementia. Comparisons of diagnoses between raters by clinical specialty revealed few systematic differences. The impact of neuropsychological input on the physician''s diagnosis was most marked in the borderline cases between diagnostic categories

ISSN:0251-5350    

DOI:10.1159/000109914

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The magnitude and importance of changes in scores of neuropsychological tests on retest in the elderly, especially over long time periods, is not well established. Three neuropsychological tests and one mental status test were initially administered to screen for potential dementia and were readministered to 380 of the surviving individuals 2.4 years later who either failed the screening examination or were an age matched control. Of the 380 women and men aged 65 and older, 56 were diagnosed as having Alzheimer disease (AD), 82 as at risk for developing AD, and 242 as having normal cognition. The present report focuses on changes in test scores between the two visits. In the normal and at risk groups, significant improvements were seen on retest of the Visual Reproduction Test (VRT), the Trails B test, and the Mini-Mental Status examination; verbal fluency decreased, and savings score of the VRT showed small variations. On most tests, scores of the AD group decreased. Practice effects, biases, and other variables may have played a role in the improvements seen in those labeled normal and at risk. If these results are confirmed, savings score of the VRT (which remained stable over time in normals and individuals at risk and decreased in patients with dementia) and verbal fluency (which decreased in all groups) may be better measures of true cognitive performance than the other tests that we evaluated.

ISSN:0251-5350    

DOI:10.1159/000109915

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000109916

出版商:S. Karger AG    

年代:1996

数据来源: Karger