ISSN:0272-4391    

DOI:10.1002/ddr.430050102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractAn overview is presented of the major psychopathologic disorders in the elderly population. Alzheimer's disease and related disorders are considered, and a review is presented of the drugs currently marketed to treat these disorders and the compounds currently under investigation. Similarly, the symptoms and pharmacologic treatment of depression, anxiety, and sleep disorders in the elderly are discussed. In general, geriatric psychopharmacology is seen as a challenging and rapidly developing field of scientific inquiry.

ISSN:0272-4391    

DOI:10.1002/ddr.430050103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractVarious types of drugs that have been proposed as treatments might alter cognitive processes. Programmatic research in this area is built upon knowledge about the psychobiological bases of learning, memory, and related cognitive processes. These efforts generally begin with promising research findings obtained from psychopharmacological studies of cognitive processes in lower animals. These findings are then integrated with what is known about the neuropathology of syndrome‐related types of cognitive failures in humans along with findings relating to the determinants of information processing in both impaired patients and unimpaired subjects. Experiments are then designed to test the cognitive response to some psychoactive drug treatment. Promising leads and preliminary claims and findings are frequently not supported by continued clinically focused research. A major reason is that studies do not adequately consider the differentiated nature of cognitive processes. This paper stresses a single theme—namely, cognitive processes are complex, differentiated, and determined by different psychobiological mechanisms and, therefore, are susceptible to change in relatively specific ways. A theoretical framework for the analysis of cognitive changes is proposed. This framework is used illustratively to profile how different types of cognitive responses may result from different types of drug treatm

ISSN:0272-4391    

DOI:10.1002/ddr.430050104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractThe most common errors in the diagnosis of dementia are underdiagnosis and overdiagnosis. Underdiagnosis is best avoided by careful use of psychometric screening tests to detect cognitive impairment in patients unaware of their own defect. Overdiagnosis can be avoided by not applying the label of “dementia” until the diagnosis is unequivocal. Complete evaluation is necessary to rule out treatable causes of dementia, and should include medical, neurological, and psychiatric history and examination, simple psychometric tests, laboratory battery, computerized transaxial tomographic brain scan, and electroencephalogram. Ultimately, the diagnosis of dementia may change at follow‐up examination, and the unequivocal diagnosis of a specific form of dementia still requires autopsy and neuropathological examination of the brain. The most common causes of cognitive impairment in the elderly include Alzheimer's disease, multi‐infarct dementia, depression, and other specific illnesses such as tumors, Jakob‐Creutzfeldt disease, and normal pressure hydrocephalus. Even systemic disease can present as dementia. The evaluation outlined above may help distinguish among these causes. New diagnostic techniques may eventually be helpfu

ISSN:0272-4391    

DOI:10.1002/ddr.430050105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractDuring the past few years, substantial progress has been made in understanding the neuropathology of Alzheimer's disease (AD) and its late‐life variant, senile dementia of the Alzheimer's type. Neurofibrillary tangles have been shown to be composed of cross‐linked, highly insoluble paired helical filaments. The disease selectively affects certain populations of nerve cells, including those in the amygdala, hippocampus, neocortex, locus coeruleus and basal forebrain cholinergic (Ch) system. Changes in the latter system account, in substantial part, for the decrease in cortical Ch markers which, to date, appear to be the earliest and most consistent abnormalities in the brains of individuals with AD. Neuritic plaques have been shown to be foci of axonal/synaptic pathology consistent with the concept that these changes may be associated with a chronic distal axonopathy involving certain populations of nerve cells. Recent studies in aged nonhuman primates suggest that some of the abnormal axons/terminals in neuritic plaques may be derived from the basal forebrain Ch system. Understanding the biological mechanisms leading to these structural changes is essential if we are to understand the pathogenesis of the clinical manifestations of AD and if we are to design rational therapeutic approaches to treat this disor

ISSN:0272-4391    

DOI:10.1002/ddr.430050106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractThis paper reviews and discusses the evidence that the primary cause of the symptoms of Alzheimer's disease is a deficiency of acetylcholine in cerebral cortex and hippocampus. Data on other neurotransmitters in this disease are briefly reviewed. Possible means of treating acetylcholine deficiences are discussed.

ISSN:0272-4391    

DOI:10.1002/ddr.430050107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

摘要:

AbstractAlzheimer's Disease (AD) is characterized neurochemically by a profound loss of choline acetyl transferase activity and histologically by a selective degeneration of cholinergic neurons originating in the nucleus basalis of Meynert (nbM). The clinical relevance of this cholinergic deficit and its implications for the development of treatment strategies was explored in animal studies and in patients with carefully diagnosed AD. A hypocholinergic animal model was developed by chemical ablation of the nbM in rats. These rats demonstrated significant impairment of learning and memory as measured by long‐term habituation of locomotor activity and retention of a one‐trial passive avoidance task, which was substantially improved after the administration of the cholinergic drug physostigmine. In AD patients, in vivo assessment of cholinergic markers in cerebrospinal fluid showed decreased acetylcholine and choline activity in proportion to the patient's degree of cognitive impairment. Physostigmine was administered to AD patients both intravenously and orally in an attempt to enhance central cholinergic activity. Significant improvement of long‐term memory encoding followed administration of intravenous physostigmine, and modest improvements in cognition and behavior resulted when oral physostigmine was given to some AD patients. These results support the hypothesis that cholinergic deficits are manifested in symptoms of AD and suggest that administration of cholinomimetic agents is a rational treatment strategy

ISSN:0272-4391    

DOI:10.1002/ddr.430050108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY

ISSN:0272-4391    

DOI:10.1002/ddr.430050101

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1985

数据来源: WILEY