ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02849.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

A Work Group on the Diagnosis of Alzheimer's Disease was established by the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) and the Alzheimer's Disease and Related Disorders Association (ADRDA).The need for this report was suggested by the National Advisory Council of the NINCDS. The report has been reviewed by workshop participants, representatives of the National Advisory Neurological and Communicative Disorders and Stroke Council, representatives of the ADRDA, and designated reviewers representing professional societies concerned with the diagnosis of Alzheimer's disease. Based on a consensus of the participants, criteria were developed to serve as a clinical basis for diagnosis. These criteria should be useful also for comparative studies of the patients in different kinds of investigations, including case control studies, therapeutic trials, evaluation of new diagnostic laboratory tests, and clinicopathologic correlations. The criteria are not yet fully operational because of insufficient knowledge about the disease. The criteria are compatible with definitions in the current Diagnostic and Statistical Manual of Mental Disorders (DSM III) and in the International Classification of Diseases.The following excerpts from the NINCDS‐ADRDA Work Group report are reproduced with permission for the interest of our readership. An accompanying editorial in this issue (page 1) comments further on the value of these criteria.—Ed

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02850.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The relative proportions of regulatory T lymphocyte subpopulations and T lymphocyte proliferative responses to the mitogen phytohemagglutinin (PHA) were studied in 30 patients with clinically apparent Alzheimer's disease (mean age = 71.5). Comparisons were made with 30 age‐matched, nondemented healthy controls (mean age = 68.8) and with 20 younger, normal adult controls (mean age = 27.5). The relative percentages of total peripheral T lymphocytes, T helper/inducer lymphocytes (Th), and T suppressor/cytotoxic lymphocytes (Ts) were similar between the Alzheimer patient group and the age‐matched controls. However, when the two older groups were compared with the young adult controls, a significant decrease was seen in the percentage of Ts cells, with a concomitant increase in the ratio of Th:Ts. Lymphocyte proliferative responses to PHA were similar in the Alzheimer patients and their age‐matched controls; however, when compared with the young adult controls, a significant decrease in responsiveness for both older groups was observed. These results confirm decreases in certain immune indices with aging, but suggest that there are no changes in T lymphocyte subsets or in lymphocyte proliferation, which are unique to Alzheimer's disease.J Am Geriatr Soc 33:4

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02851.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

One hundred and seventy‐six homebound elderly patients referred for psychiatric evaluation by family, physician, or community agency were assessed in the home by a geriatrician psychiatrist, accompanied by those involved with the patient's care, whenever possible. Careful attention was paid to the interaction between psychiatric, medical, and social parameters and their collective effect on the aging patient. The most common discrete psychiatric diagnoses were dementia, with or without secondary symptoms; major depression; and paranoid states without dementia. Assessment resulted in home treatment and maintenance through a variety of supportive interventions frequently accompanied by chemotherapy, emergency psychiatric and medical hospitalization, and placement, as well as education of family and community workers.J Am Geriatr Soc 33:9, 19

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02852.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

During 26 years of surveillance of the Framingham Study Cohort of 5,209 subjects, 176 men and 119 women developed occlusive peripheral arterial disease manifested as intermittent claudication (IC). The incidence increased sharply with age until the age of 75, with about a twofold male predominance at all ages. An incidence of IC comparable to that of angina pectoris was obtained ten years later in life than for angina pectoris. Cigarette smoking, impaired glucose tolerance, and hypertension were powerful predisposing factors. Impaired glucose tolerance was a greater risk in women than in men, and glycosuria carried a greater risk than other indicators of impaired glucose tolerance. Cigarette smoking had about the same impact in men and women, approximately doubling the risk, and the impact was discernible into advanced age. Hypertension increased risk 2.5‐ to fourfold, respectively, in men and women. A low vital capacity was associated with a substantial excess risk. Electrocardiographic evidence of left ventricular hypertrophy predicted IC in both sexes. Serum cholesterol, relative weight, and hematocrit were weak risk factors. A risk profile made up of the major cardiovascular risk factors was better for predicting IC than for predicting coronary heart disease. Mortality was increased two‐ to fourfold in men and women, respectively, mainly because of coexistent cardiovascular disease.J Am Geriatr Soc 33:13,

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02853.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

To better define the effect of age on blood pressure in patients with hyperthyroidism, the blood pressures of 321 patients with hyperthyroidism were compared with those of 324 euthyroid controls. Subjects were divided into four age groups by decade from 20 to 59 years. The systolic, but not diastolic, blood pressure in the patients with hyperthyroidism was significantly higher in all age groups. Among the euthyroid controls, the systolic blood pressure increased with age. However, no age‐related increase was apparent among the hyperthyroid patients because of the relatively high systolic blood pressure in young patients. Effective antithyroid treatment reduced the systolic blood pressure significantly in hyperthyroid patients. The reduction of systolic blood pressure was greater in the younger hyperthyroid patients than that in the older ones, so that an age‐related increase in systolic blood pressure was present after a euthyroid state had been achieved. These results provide evidence against the report that in hyperthyroidism, hypertension tends to occur in older patients, and suggest that the effect of excessive thyroid hormone on the systolic blood pressure may differ according to age.J Am Geriatr Soc 33:19,

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02854.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

As part of an interview survey of a defined population of 3,097 rural persons 65 years and older (the Iowa 65+ Rural Health Study), the prevalence and functional correlates of specifically defined low back pain were studied. Low back pain was reported by 23.6 per cent of the women and 18.4 per cent of the men in the year prior to the survey, with prevalence rates declining with age. Forty per cent of those with low back pain noted its presence at the time of the interview. Over half had used analgesics. Use of medical and chiropractic services for this symptom was nearly 75 per cent; 25 per cent had at least one hospitalization directly related to low back pain and over 5 per cent had low back surgery. Limitation of walking, sitting, bending over, and performing household chores was reported by 15 to 40 per cent, and 21 per cent attributed sleep disturbance to the low back pain. Nearly 75 per cent of subjects with low back pain reported first onset of the problem prior to age 65, which has important implications for pathogenesis and prevention. The functional and clinical burdens of low back pain in this population of rural elderly were substantial and require further evaluation of risk factors and impact on health status.J Am Geriatr Soc 33:23, 1985

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02855.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Twenty‐five geriatric patients with severe motor urge incontinence were treated with terodiline and meladrazine separately and in combination. Because of poor general state of health and serious concomitant diseases the frequency of dropouts was high. Separate administration of the drugs improved the majority of the patients subjectively, but not sufficient for complete continence. Urodynamically, however, significant improvement was found only with terodiline. On combined administration with both drugs, seven of 15 patients became completely continent, seven were improved, and one remained unchanged, but additional urodynamic improvement was not demonstrated. Meladrazine caused a high incidence of side effects; therefore, treatment with terodiline separately is recommended for geriatric patients who have severe motor urge incontinence.J Am Geriatr Soc 33:29, 19

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02856.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Nursing Home Care Units in Veterans Administration Medical Centers across the country were surveyed to determine methods of management of urinary incontinence (UI) in the nursing home (NH) setting. Information was obtained from 90 of the VA NHs on demographic aspects of the NH population, prevalence and severity of urinary and fecal incontinence, common problems encountered, and specific strategies and techniques. Written guidelines for bladder training and catheter care from many of the NHs were analyzed. The results of the survey reinforce the need for research designed to improve the care of the incontinent NH patient.J Am Geriatr Soc 33:33, 1985

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02857.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Perforating foot ulcers constitute a major problem in diabetics with peripheral neuropathy for which no specific therapy is available. Twenty patients with chronic, resistant mal perforant were treated by local application of dimethylsulfoxide (DMSO) solution. Complete healing of the ulcers was achieved in 14 patients following 4–15 weeks of daily treatment. Partial resolution was observed in another four patients, and in the remaining two there was no effect. A control group, equal in number, was treated conventionally. Complete healing of the ulcers took place in only two patients. The therapeutic effect of DMSO most probably results from an increase in tissue oxygen saturation via a combined mechanism of local vasodilatation, decreased thrombocyte aggregation, and increased oxygen diffusion. Local DMSO is effective, simple, devoid of systemic side effects, and inexpensive. It should be employed for diabetic foot ulcers prior to the consideration of surgical measures.J Am Geriatr Soc 33:41, 19

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb02858.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY