ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The topic of vascular depression has received increasing prominence as a putative etiology of depression in later life. The authors examined one aspect of this model by comparing the burden of systemic cerebrovascular risk factors (CVRFs) in 130 psychiatric inpatients with major depression and 64 normal control (NC) subjects, all age ≥50 years. Depressed subjects did not differ statistically from NCs on cumulative CVRF scores. Diabetes mellitus and atrial fibrillation were both associated with depression, but only atrial fibrillation retained an independent association after medical disability was statistically controlled. Among the depressed subjects, CVRF scores were not significantly associated with overall symptom severity, psychiatric disability, age at onset of depression, melancholic subtype, or psychotic depression. These data did not support the notion that a linear model of small-vessel disease might apply to the great majority of older inpatients with major depression.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors examined the rates and correlates of depressive symptoms in adults over age 60 admitted to community hospital settings and compared them with patients admitted to a tertiary-care medical center. Rates of depressive symptoms in patients admitted to five different community hospitals in North Carolina were compared with each other and with a sample of 542 elderly medical patients admitted to Duke University Medical Center (DUMC). Compared with patients at DUMC, community-hospital patients were older and had more cognitive impairment, but had less severe medical illness and shorter hospital stays. The proportion of depressed community patients was significantly higher than among patients admitted to DUMC. In four of the five community hospitals, rates of significant depressive symptoms exceeded 50%. Health correlates of depression were admitting diagnoses other than cardiovascular disease, poor cognitive functioning, and severe medical illness.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors evaluated the relationship of personality disorder symptoms to disability and social and interpersonal functioning in geriatric depression. Measures of personality disorder and cognitive, affective, social, interpersonal, medical, socioeconomic factors, and instrumental activities of daily living (IADL) status were administered to 47 elderly patients at various levels of remission from major depression. Total personality disorder scores were inversely associated with IADL, sociability, and presence of a satisfying relationship, both alone and in interaction with depression. The associations between personality disorder and functioning were most prominent in subjects with low residual depression. Symptoms of personality disorder in elderly patients may be associated with disability and impaired social and interpersonal functioning after an acute depressive episode; personality disorder symptoms may also have treatment implications for geriatric depression.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

To investigate the hypothesis that elevated serum anticholinergic activity is independently associated with delirium in ill elderly persons, the authors performed a cross-sectional study of 67 acutely ill older medical inpatients. The presence of delirium was evaluated with the Confusion Assessment Method, and the presence of many delirium symptoms was measured by the Delirium Symptom Interview. Demographic data and clinical characteristics that may be important for the development of delirium were also collected. Logistic regression techniques demonstrated that elevated serum anticholinergic activity was independently associated with delirium. Among the subjects with delirium, a greater number of delirium symptoms was associated with higher serum anticholinergic activity.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors studied the cognitive, affective, and functional status of 172 mentally healthy patients, age 55 and older, who were undergoing elective surgery under general anesthesia. Patients were interviewed before and after surgery; this report focuses on changes 1 month postoperatively. Authors compared the mental status and function of 190 nonsurgical patients of comparable age. Surgical patients showed a temporary functional decline. Linear regression predictors of affective, cognitive, and functional change at follow-up included demographics, baseline measures of mental status and function, surgery type, and intraoperative measures. Longer duration of anesthesia—but not type of surgery—predicted short-term decline in activities of daily living but not cognition or affect. Authors discuss results in the context of previous findings in which surgery had no impact on mental status or function at 10-month follow-up.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors selected 69 participants from an Alzheimer's disease research registry and diagnosed them as depressed or nondepressed by use of a semi-structured clinical interview. Responses to selected BRSD items were compared between the depressed and nondepressed groups. Differences between responses of the two groups on BRSD items related to anxiety and depression were significant. The groups did not significantly differ in their responses to items related to other content areas. On the basis of their responses to the BRSD anxiety and depression items, 70% of participants were correctly classified as depressed or nondepressed.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ECGs of 50 patients who completed a long-term nortriptyline (NT) study are presented at baseline, after 7 weeks on NT, and after 1 year. The ECGs of patients with preexisting cardiac disease were compared with non-cardiac patients. Significant ECG changes and increases in heart rate were observed by Week 7 and persisted at a mean of 55 weeks (range: 24–111) in patients who were continued on NT. No significant difference was found in long-term ECG effects in patients with preexisting cardiac disease; ECG changes reverted to baseline when placebo was substituted. Patients with known cardiac disease did not show significantly worse ECG changes on NT than non-cardiac patients.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors compared various strategies for recruiting elderly subjects with bereavement-related depression into a randomized clinical trial. Over 5 years, they empaneled 65 patients from a total of 441 subjects screened (14.7%). Response to media advertisements was the single most effective strategy (54% of subjects). Another effective, but labor-intensive, strategy was using letters to bereaved spouses found through newspaper obituaries (14%); another 14% were referred by friends who had seen study advertisements. Information letters to healthcare providers yielded no study participants. Pathways to study participation did not differ as a function of race or gender and did not influence study retention or remission rates. Our experience suggests that successful intake depends on a personal mode of recruitment.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The authors examined whether the presence of extrapyramidal side effects (EPS), measured before neuroleptic treatment was initiated, could be used to predict the development and severity of neuroleptic-induced parkinsonism (NIP) in Alzheimer's disease (AD). Twenty-four newly medicated probable AD patients were assessed with a battery of measures of extrapyramidal motor function. Assessments were made before neuroleptic therapy, and 3 and 9 months after treatment. Posttreatment clinical findings revealed that 66.7% of the AD patients developed NIP. Patients who developed NIP exhibited more severe pretreatment bradykinesia on instrument-derived measures. These findings suggest that a substantial proportion of AD patients treated with neuroleptics develop significant EPS and that the risk for EPS can be estimated before intervention by use of instruments measuring motor function.

ISSN:1064-7481    

出版商:OVID    

年代:1998

数据来源: OVID