ISSN:0885-6230    

DOI:10.1002/gps.930090102

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractIn the Kungsholmen project, a longitudinal study of a total population, samples of non‐demented and demented elderly persons with a depressive disorder were followed over 3 years. Of 668 persons who received a full medical examination, 62 were found to have a depressive disorder. Of these, 28 were demented and 34 non‐demented. Two‐thirds of the 62 had not been previously recognized as having a depressive disorder. There was no difference in this regard between the demented and non‐demented samples. After 3 years, only two out of 20 non‐demented cases had recovered from their depressive disorder. This is in contrast to the demented cases, where only one of 11 were still depressed. These results indicate the need for greater attention to the recognition and management of depressive disorders in th

ISSN:0885-6230    

DOI:10.1002/gps.930090103

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractIn a 4‐year follow up of 1042 elderly people (aged 65+) randomly sampled from the community, levels of dementia were assessed using a two‐phase case‐finding procedure (screening followed by clinical interview) among survivors, with additional information provided by death certificates, hospital case notes or postal questionnaires. Overall, 42 cases were clinically identified. In a case‐control analysis matching for age, sex and premorbid cognitive status, risk estimates were obtained for nine self‐reported factors: heart trouble; headaches; giddiness; falls; current smoking; past smoking; left handedness; insomnia; and the use of sedative‐hypnotic drugs to promote sleep. While none of these factors was associated with a significantly increased risk, the power of these case‐control comparisons was limited b

ISSN:0885-6230    

DOI:10.1002/gps.930090104

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractAlthough increasing interest has been focused on falling in the elderly, little is known about the incidence and consequence of falls in psychogeriatric outpatients. We conducted a 1‐year prospective study of falling in 102 community‐dwelling elderly patients with psychiatric morbidity (mean age: 70 years) and 100 mentally intact elderly patients (controls, mean age: 74 years). The subject group comprised 79 patients with depression, 14 with dementia and nine with combined disease based on DSM‐III‐R criteria. Overall, 216 falls in the subject group and 54 in the controls were reported. At the end of the study, recurrent fallers aged 75 years and older showed significant physical deterioration. Multiple logistic regression analysis of selected medical and demographic variables indicated that the most influential variable regarding falling of the subjects was severity of depression rated using the Hamilton scale. Unexpectedly, the analysis revealed that the use of antidepressants was associated with a lower likelihood of falling. On the basis of the two variables, 75% of all respondents were correctly classified as fallers or non

ISSN:0885-6230    

DOI:10.1002/gps.930090105

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractAnecdotal evidence suggests that some old age psychiatrists are dissatisfied and disillusioned with their local autopsy services, and so we carried out a postal survey to assess the extent of the problem. Our most striking finding was that over a quarter of old age psychiatrists are, indeed, dissatisfied with the way other organ systems were examined. This dissatisfaction is very strongly associated with services where autopsies on psychogeriatric patients are carried out by general histopathologists, especially where there is no established facility for the brain to be preserved and subsequently examined by a neuropathologist. The main complaint about neuropathologists was that reports sometimes took an unacceptable length of time to be returned to the clinician. The solution to the difficulties experienced by old age psychiatrists would be a closer association with their local neuropathology services, but whether neuropathologists are in a position to increase their workloads remains to be determined.

ISSN:0885-6230    

DOI:10.1002/gps.930090106

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractNine elderly patients with major depression were followed for outcome of continuation ECT. All nine patients had poor response to pharmacotherapy of the index episode, favorable response to acute treatment with ECT and, to varying degrees, previous failure of prophylactic pharmacotherapy. Four of the nine patients complied with continuation ECT as recommended for periods of 9 months to 1 year; these patients remained essentially well during the follow‐up period, while the five who stopped the treatment prematurely fared poorly (one died, one required chronic hospitalization and three where rehospitalized acutely). These findings suggest the need for controlled studies of continuation ECT in geriatric depressio

ISSN:0885-6230    

DOI:10.1002/gps.930090107

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractPatients tend to get referred to psychogeriatricians late in the course of a dementing illness, often when a crisis has occurred and carers can no longer cope. Earlier referral is disirable, but generates extra work for the psychogeriatrician. Nurse screening may overcome this. In this study a nurse, trained in the administration of the CAMDEX structured interview and supervised by a psychogeriatrician, performed a diagnostic assessment on patients with early cognitive impairment referred from primary care. This initial phase of the study sought to validate the nurse's assessment, and found that in 33 patients with possible early cognitive impairment, there was good broad agreement between the nurse's diagnosis and a psychogeriatrician's diagnosis supported by standardized rating scales. Nurse screening may be a cost‐effective means for a secondary care psychogeriatric service to provide support to general practitioners, form a case register of patients with early dementia, and follow these patients through as their dementia progresse

ISSN:0885-6230    

DOI:10.1002/gps.930090108

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractWhile in most western countries the early diagnosis and community management of dementing disorders in the elderly is very much the responsibility of the general practitioner, a number of studies suggest general practitioners to be poorly prepared for such a task. In a postal questionnaire of 301 general practitioners in the Montpellier region of France, wide variations were found in clinical practice. Of particular concern was failure to use standardized instruments in the diagnosis of cognitive deficits and the high prescription rate of inappropriate laboratory and neurological examinations. The results of the study suggest areas in which general practice procedures may be altered to reduce false positive diagnoses.

ISSN:0885-6230    

DOI:10.1002/gps.930090109

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractFifteen carers of people with presenile dementia in the London Borough of Sutton were interviewed about their experiences of the services that had been provided to them. The carers were generally satisfied once they had been referred for specialist help and they would have liked more support and information around the time of diagnosis. When asked about what additional services were required, carers were particularly concerned about the lack of appropriate day care for their relative. Carers whose relative had been admitted to long‐term care reported finding the process of admission distressing. High levels of stress were found among all the carers. The importance of providing emotional support to this group of carers is emphasize

ISSN:0885-6230    

DOI:10.1002/gps.930090110

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe wellbeing of attenders of an old age psychiatry day hospital and their carers was assessed as the unit closed over a 2‐week period. Decline in the wellbeing of carers and attenders was seen with a regression to preclosure levels. The results suggest the importance of the day hospital to the patients and their carers. The problems of evaluation at short notice are discusse

ISSN:0885-6230    

DOI:10.1002/gps.930090111

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY