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The Brief Kingston Standardized Cognitive Assessment - Revised
- Authors:
- HOPKINS Robert W., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(3), March 2005, pp.227-231.
- Publisher:
- Wiley
The Kingston Standardized Cognitive Assessment - Revised (KSCA-R) was designed to be a cognitive screening tool available to health professionals who were not trained in specialized cognitive assessment techniques. It was introduced to bridge the gap between brief, narrowly focused rating scales, and intensive, expensive, full neuropsychological assessments. We now present the Brief Kingston Standardized Cognitive Assessment - Revised (BriefKSCA-R). Groups of Alzheimer's disease patients, patients suffering from other dementias, and a group of normal community dwelling elderly were assessed using the BriefKSCA-R. This shortened version of the full Kingston Standardized Cognitive Assessment - Revised can be given in half the time while retaining most of the full KSCA-R's effectiveness. Suitable for a quick screening, or follow-up of patients already more fully assessed.
Alzheimer's Disease and dementia
- Author:
- ROYAL COLLEGE OF PSYCHIATRISTS
- Publisher:
- Royal College of Psychiatrists
- Publication year:
- 1999
- Pagination:
- 10p.
- Place of publication:
- London
Part of a series of booklets describing a range of mental health problems, aiming to make people more understanding of what these are and of the people who suffer from them. This pamphlet looks at Alzheimer's Disease and dementia, particularly in older people.
The natural history of mental disorder on old age. Martin Roth, Journal of Medical Science (1955) 101, 281-301
- Author:
- BURNS Alistair
- Journal article citation:
- International Journal of Geriatric Psychiatry, 11(1), January 1996, pp.7-14.
- Publisher:
- Wiley
This article is part of a series in which key papers in old age psychiatry are presented with an introduction, commentary by the original author and current update by someone working in the field. The paper was the first attempt to differentiate the features of clinical psychiatric illness in later life and has been comprehensively summarized. The salient findings of the paper are presented and discussed.
A witness seminar: the development of old age psychiatry in Britain, 1960-1989. Themes, lessons and highlights
- Authors:
- HILTON Claire, ARIE Tom, NICOLSON Malcolm
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(6), June 2010, pp.596-603.
- Publisher:
- Wiley
A medical history witness seminar is a form of oral history, where people associated with a particular health care development meet with former colleagues to discuss, reflect and present their account of key changes with which they had involvement. This article describes one such meeting, and creates a record of the development of old age psychiatry in Britain, as seen through the eyes of some of the people who participated in building it, from its inception until it was officially recognised as a specialty by the Department of Health in 1989. The group discussions were in the format of a witness seminar, which was audio-recorded and transcribed, and witnesses also provided written biographical information. While early old age psychiatrists had often encountered opposition from other health care professionals and managers, their experiences were demonstrating just how much could be achieved in improving the lives of older mentally ill people. This paper describes how they conveyed their enthusiasm for their work in both clinical and university settings. Clinical creativity, support when working in professional isolation, and dealing with opposition benefited from both the development of the Group for the Psychiatry of Old Age at the Royal College of Psychiatrists and from close links with existing geriatric medicine.
Effects of memantine on behavioural symptoms in Alzheimer's disease patients: an analysis of the Neuropsychiatric Inventory (NPI) data of two randomised, controlled studies
- Authors:
- GAUTHIER S., WIRTH Y., MOBIUS H. J.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.459-464.
- Publisher:
- Wiley
Behavioural symptoms are common in moderate to severe Alzheimer's disease (AD). We have analysed the databases of two randomised studies with regard to the effects of memantine treatment on behavioural symptoms, measured using the 12-item version of the Neuropsychiatric Inventory (NPI). The monotherapy study (memantine only) reported by Reisberg et al. (2003) involved 252 patients with baseline MMSE total score of between 3 and 14, whereas the combination study (memantine and donepezil) reported by Tariot et al. (2004) comprised 404 patients with MMSE scores of between 5 and 14. In both studies, patients received 10 mg memantine b.i.d. or matching placebo, and lived in the community. For both studies NPI total and individual domains scores were analysed in the ITT population. For the monotherapy study a dichotomised analysis was performed separately for patients who had behavioural symptoms at baseline and for those without pre-existing symptoms. Furthermore, a factor analysis was used to identify any behavioural clusters within the patient population. In both studies, the change in NPI total scores at endpoint was consistently in favour of memantine treatment, reaching statistical significance in the combination study (p = 0.002). Memantine treatment showed a significant beneficial effect in comparison to placebo treatment in the NPI agitation/aggression domain in both studies (p = 0.008; p = 0.001). The dichotomised analysis of the monotherapy study showed that there was significantly less agitation/aggression emerging in the memantine-treated group compared to placebo (p = 0.003). Factor analysis showed that hyperactivity accounted for 27% of the data variance. Memantine has a beneficial effect on the behavioural symptoms of patients with moderate to severe AD, with the most pronounced effect on agitation/aggression.
Childhood conduct problems, stages of Alzheimer's disease, and physical aggression against caregivers
- Authors:
- O'LEARY Daniel, JYRINGI Darlene, SEDLER Mark
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.401-405.
- Publisher:
- Wiley
One hundred and ninety-eight individuals with dementia, primarily Alzheimer's disease (AD) were evaluated with the Cohen-Mansfield Agitation Inventory, the Mini Mental Status Examination, two measures of Activities of Daily Living, portions of the Conflict Tactics Scale to measure physical aggression against partner, questions about conduct problems during childhood/adolescence of the patients, and chart records of delusion and paranoia. 25% of the patients engaged in physical aggression against their caregivers in the past year, and 33% of the patients engaged in some act of physical aggression against any individual in the past two weeks. Physical aggression against a caregiver was more likely in the middle (34%) than the early stage of AD (4%). Physical aggression against a partner and agitation were more likely if the patient had a history of symptoms of conduct disorder. Delusions and paranoia were both associated with general physical aggression and general verbal aggression but not physical aggression against a caretaker. 25% of Alzheimer's disease and Multi-Infarct dementia patients engaged in acts of physical aggression against their caregivers. The rate of aggression seen in this clinical sample was much higher than the rate of physical aggression in a community sample of the elderly.
VITA: subtypes of mild cognitive impairment in a community-based cohort at the age of 75 years
- Authors:
- JUNGWIRTH S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(5), May 2005, pp.452-458.
- Publisher:
- Wiley
Mild cognitive impairment (MCI) is defined to diagnose prodromal dementia and prodromal Alzheimer dementia, in particular. The main aim of this study is to identify subtypes of MCI in comparison to the frequency of Petersen's MCI-amnestic in an elderly age-cohort. The study is based on the cross sectional data from the Vienna-Transdanube-Aging (VITA) study. The data refer to the age cohort of 592 individuals at age 75 to 76 years who completed extensive neuropsychological examination. Dementia was present in 15 subjects (2.5%, CI: 1.4-4.1). 141 subjects (23.8%, CI: 20.4-27.5) of the entire age cohort 75 (n = 592) showed cognitive impairment without dementia concerning one or more cognitive functions (1.5 SD paradigm). These subjects were assigned to three subtypes of MCI: Selective Memory Impairment: n = 22 (3.7%, CI: 2.3-5.6), Memory Impairment+Non-Memory Impairment: n = 31 (5.2%, CI: 3.6-7.4) and Non-Memory Impairment: n = 88 (14.9%, CI: 12.1-18.0). The frequency of MCI-amnestic, the so-called prestage of AD according to Petersen, was very low (0.5%, CI: 0.1-1.5) compared to the estimated incidence rates of AD at this age. Established criteria of MCI could be modified in order to include a higher percentage of high-risk subjects for later developing Alzheimer dementia.
Social distance towards a person with Alzheimer's disease
- Author:
- WERNER Perla
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(2), February 2005, pp.182-188.
- Publisher:
- Wiley
This study examined determinants of behavioral discrimination (i.e. social distance) against persons with Alzheimer's disease (AD). Face-to-face interviews were conducted with a total of 206 Jewish Israeli adults (mean age = 59.7) using an experimental vignette methodology, varying in the severity of the disease. Information regarding participants' preferences for social distance from a person with AD was elicited. The effects of emotional reactions, perceptions of dangerousness of the person depicted in the vignette, personal experience with the disease, and perceptions about the susceptibility of developing AD were examined. Results of the study provide partial support for an extended version of the attribution model, in that prosocial feelings were found to decrease the behavioral discrimination against the person described, whereas feelings of rejection increased the discrimination. A direct, unmediated effect of the severity of the disease on social distance was found, as well as a direct effect of familiarity with someone with the disease. Findings of this study stress the importance of increasing government and advocacy initiatives that would provide the lay public with accurate knowledge about the disease, its symptoms, and treatments. These campaigns should be aimed at clarifying misconceptions and communicating empathetic feelings towards people diagnosed with AD.
A longitudinal study of Alzheimer's disease: rates of cognitive and functional decline
- Authors:
- SUH Guk-Hee, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(9), September 2004, pp.817-824.
- Publisher:
- Wiley
The aim was to measure rates of decline in cognition and function in patients with Alzheimer's disease (AD) and to investigate their accelerating risk factors in Korea. This study presents longitudinal data on a community-based sample of 107 patients with AD, followed at 6 months and 12 months. The cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), the Mini Mental State Examination (MMSE) and the Disability Assessment for Dementia Scale (DAD) were given. Mixed model analyses were conducted using the following independent variables: times of repeated assessment (0, 6 or 12 months), severity of dementia assessed by the Functional Assessment Staging (FAST) and individual indicators as covariates. Average annual rates of decline in the MMSE, the ADAS-cog and the DAD were 2.3, 11.4 and 15.1 points, respectively. Neither gender, duration of formal education, nor duration of AD since onset was significant predictors of cognitive and functional decline. Patterns of functional decline in total DAD, instrumental ADLs, planning and organization and performance subscale are linear as MMSE score declines, while those of the basic ADLs and the initiation are curvilinear. This naturalistic observational study measured rates of cognitive and functional decline in AD, and can provide reference data for further longitudinal studies or clinical trials. Further study will be necessary to determine whether linear or curvilinear pattern in functional decline is due to progression of AD itself or statistical artifact.
Smell identification test as an indicator for cognitive impairment in Alzheimer's disease
- Authors:
- SUZYKI Y., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(8), August 2004, pp.727-733.
- Publisher:
- Wiley
The aim of the present study was to assess olfactory dysfunction in patients with Alzheimer's disease (AD) and to compare utility of the olfactory tests as possible clinical markers. Two olfactory identification tests (The Cross-Cultural Smell Identification Test [CC-SIT] and the Picture-based Smell Identification Test [P-SIT]) and the Mini Mental State Examination (MMSE) were administered to patients with AD and age-matched controls. Apolipoprotein E (Apo E) genotypes of patients with AD were identified. Patients with AD had significantly lower olfactory identification scores than age-matched non-demented elderly subjects in both olfactory assessments. In the AD group, the coefficient of correlation between the MMSE scores and the P-SIT scores was higher than that between the MMSE scores and the CC-SIT scores. Receiver operating curve (ROC) analyses for both tests indicated that the P-SIT discriminated AD patients from controls more reliably than did the CC-SIT. Within AD patients, those who were carrying one or two ApoE 4 alleles had a higher coefficient of correlation between the MMSE scores and the P-SIT scores than patients without the ApoE 4 allele. The results suggest that a short and simple non-lexical olfactory identification test can be useful as a clinical marker of AD appropriate for Japanese elderly population