ISSN:0885-6230    

DOI:10.1002/gps.930070102

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe present study describes the development of a measure of stress in the family caregivers of institutionalized dementing elders using a brief two‐dimensional scale. Univariate and multivariate analysis of the responses of 257 French adult caregivers to the scale suggest that a year after the admission to care unhappiness is expressed by a third of the population, principally due to exclusion from the caregiving role, financial burden, problems with family and poor contact with staff. Responses appear to be independent of the degree of dementia, the presence of associated pathology in the institionalized elder and recency of admission. Significantly greater satisfaction with care lower levels of stress were reported by caregivers with a relative in non‐medical communal care as opposed to a long‐stay hos

ISSN:0885-6230    

DOI:10.1002/gps.930070103

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractGeriatric clinicians have observed that some demented individuals show increased agitation, restlessness and confusion in late afternoon, evening or night. This has popularly been named ‘sundowning’, or the ‘sundowning syndrome’. References to ‘sundowning’ in clinical writings disagree on virtually every aspect of the syndrome, and little research has been conducted to investigate this phenomenon.In this study, agitation was measured in terms of motor activity, using an electronic monitor with a movement sensor. A total of 12 demented Alzheimer's patients were continuously monitored for four days each. Analyses indicated that some subjects showed increased afternoon activity, but these individuals did not correspond to nursing‐assigned groups of ‘sundowners’ and ‘non‐sundowners’. Movement correlates of ‘sundowning’ were seen in Alzheimer's patients presumably in the mid‐stages of the dementia, and less so in patien

ISSN:0885-6230    

DOI:10.1002/gps.930070104

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractFifty‐three hospitalized elderly men with medical illness were diagnosed with major depressive disorder and followed up for a mean of 2.3 months. Documentation and management of the depression by medical housestaff during the followup period were examined. There was no note of depression in the medical records of 44% of depressed patients, and depression was on the active problem list of only 32%. Followup and management plans for the depression after discharge were documented in 29%. No form of treatment was prescribed for 44% of depressed patients. Outcomes were determined by psychiatric evaluation at the end of the followup period. Of the 33 patients still alive and evaluated at followup, 64% had persistent depression, 18% improved, and 18% were in complete remission. No baseline patient sociodemographic or health characteristic, including severity of depression, was significantly related to improvement. Likewise, neither extent of documentation nor treatment implemented by housestaff was a significant predictor of outcome. We conclude that serious clinical depression in medically ill older patients may persist for a considerable period after hospital discharge and neither detection nor current management strategies appear to have a major impact on outcom

ISSN:0885-6230    

DOI:10.1002/gps.930070105

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractComputer‐assisted measurements were made on the computed tomography (CT) scans of 14 patients meeting ICD‐9 diagnostic criteria for late paraphrenia, seven of whom had exhibited one or more first‐rank symptoms during their illness. When the CT scans of all 14 late paraphrenics were compared with those of an age‐matched healthy control group, there were no significant differences with regard to planimetric measurements of brain and ventricle areas. Comparison of the scans of late paraphrenics with first‐rank symptoms and those without them demonstrated that late paraphrenics without first‐rank symptoms had a greater degree of cerebral atrophy, which was significantly so for the left frontal lobe. The findings support the observation that late paraphrenia is a heterogeneous condition which is comprised of a group with first‐rank symptoms who probably represent late‐onset schizophrenia and a group without first‐rank symptoms who have structural brain abnormalities and a presumed organic substrate for their symptoms that is impossible to exclude through cl

ISSN:0885-6230    

DOI:10.1002/gps.930070106

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe characteristics of all the patients admitted to an acute psychogeriatric admission ward over a 24‐month period were examined. The patients who had been responsible for acts of violence on the ward were compared with those who had not. Violent patients were likely to be younger, not to be depressed, to have dementia, and to be discharged to a more dependent setting, particularly a long‐stay psychogeriatric ward. The implication of this for adequate provision of psychiatric and social services is discussed. Levels of violence were low with only a small number of patients exhibiting violent behavi

ISSN:0885-6230    

DOI:10.1002/gps.930070107

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe article discusses the potential of three assessments of language function in the diagnosis of early dementia. Seventy patients (mean age 68.0 yr) attending a memory clinic were assessed using three language tests: the Boston Naming Test, a semantic, and a phonemic word fluency measure. Results of these assessments were compared with those of clinical diagnosis including the Mini‐Mental State Examination. The patients were classified by probable diagnosis as (i) dementia (N=23), (ii) minimal cognitive impairment (N=18) and (iii) other, mainly depression (N=29). Of the 23 patients in the dementia group, 18 (78.%) had a deficit on the Boston Naming Test, while only 11 (47.8%) were classified as demented on the Mini‐Mental State Examination using a cut point of<24. Nine of the 18 patients (50%) with minimal cognitive impairment had a deficit using the Boston Naming Test, while one did using the Mini‐Mental State Examination. Factors such as age, sex and language of origin, which may have influence on language performance, are discussed. Age did not affect performance, but sex and language of origin did appear to. It is concluded that there is evidence for the inclusion of certain semantic language tests in any assessment of early dem

ISSN:0885-6230    

DOI:10.1002/gps.930070108

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe regular use of psychotropic drugs in all patients aged 70 yr and over who were registered at the home nursing centre was studied. 27.4% of the patients used psychotropic drugs, 11.9% used antipsychotics, 14.6% anxiolytics and hypnotics/sedatives and 6% antidepressants. The use of antipsychotics was increased in mentally impaired patients and in wandering, restless aggressive persons, but declined with increasing age. Anxiolytics and hypnotics/sedatives and antidepressants were more frequently used by apathetic/passive/anxious patients. The dosage of antipsychotics declined with age. The doses are usually in line with general suggestions. Drugs in which the efficacy is judged by the patients themselves seem to be taken in higher doses than drugs in which the efficacy is determined by the physician.

ISSN:0885-6230    

DOI:10.1002/gps.930070109

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe prevalence of organic impairment, depressive illness and anxiety was assessed in 32 subjects (group A) within two weeks of admission to one of four local authority homes for the elderly in Fife, Scotland. This group was compared with an age and sex matched control group (group B) who continued to live at home. Both groups were reinterviewed six months later.Levels of organic impairment, depression and anxiety were significantly higher in group A at the time of admission. At follow‐up, levels of organic impairment and depression remained unchanged in both groups. The level of anxiety was significantly lower in group A but remained unchanged in group B at follow‐up.Forty per cent (13 subjects) of group A were diagnosed at first interview as suffering from major depressive episode, minor depressive disorder, generalized anxiety disorder and/or phobic disorder but no‐one was receiving treatment.This study reinforces the case for specialist assessment prior to admission to residential care as advocated by the British Geriatric Society. Improved liaison between social and psychiatric services is essential if psychiatric morbidity in the elderly is to be identified and treated, and residential places are to be used appropri

ISSN:0885-6230    

DOI:10.1002/gps.930070110

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:0885-6230    

DOI:10.1002/gps.930070112

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY