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Background Limited data exist on the impact of dementia in developing nations, including its association with mortality. Objective The purpose of this paper is to assess the relationship between dementia and five-year mortality on a community dwelling elderly Yoruba population in the developing country of Nigeria and to compare those results with those from an elderly African–American community in Indianapolis. Methods A two-phase design was used to ascertain dementia status in two sites. In the first phase, the Community Screening Instrument for Dementia (CSI-D) was administered. In the second phase, subjects were sampled for the clinical assessment according to their CSI-D performance category. Proportional hazards regression was used to assess the relationship between mortality and cognitive status at both sites after adjusting for demographics and chronic disease conditions. Results For the entire screened population, poor and intermediate performance on the CSI-D is associated with increased mortality at both sites; however the effect of CSI-D performance did not significantly differ between the two sites. For the clinically assessed sample, dementia was significantly associated with increased mortality at both sites (Ibadan RR = 2.83, Indianapolis RR = 2.05), but the effect was not significantly different across the two sites. Conclusion Dementia resulted in an increased risk of mortality for Yoruba of a magnitude similar to African–Americans suggesting that the impact of dementia on mortality risk may be similar for developing and developed countries. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Age-related declines in balance and muscle power are largely responsible for the changes in the various components of gait performance among elderly people. But these can often be remedied with strength training. People with cognitive impairment frequently demonstrate impaired gait, putting them at increased risks for falls and serious injury. Objectives This paper reports on the effects of a six-week pilot study of moderate intensity strength training on the gait of elderly individuals with dementia who attend a day-care center. Methods Twenty-six adults (23 female, three male), age = 79.2 ± 6.6 years, completed the study. Each subject completed a baseline assessment of lower extremity strength and gait. Gait was evaluated using free- and fast-gait speed over a 6-meter course, the Tinetti-Gait Assessment scale, the ‘Timed-Up-and-Go’, and the Gait Assessment Rating Scale (GARS). The intervention consisted of moderate-intensity progressive resistance lower extremity exercise using Theraband, for two to three sessions per week over the six weeks. Post-intervention assessment of strength and gait was repeated at the completion of the sixth week. Multiple paired t -tests were calculated for each outcome measure. Results The baseline assessment of gait suggests a high degree of frailty and risk for falls in the sample. Although post-intervention scores reflected improvement on all gait measures, the only statistically significant change observed was in fast-gait time. Conclusion A six-week resistance training program proved to be of insufficient duration, intensity or specificity to produce significant change in gait outcome measures, with the exception of fast speed gait. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

ObjectiveTo evaluate the effect of selegiline in the treatment of patients with Alzheimer's disease, in terms of cognitive performance, functional ability, emotional state (including behaviour and mood) and global response. Data SourcesThe Cochrane database of trials, Embase, Medline and Psychlit. Study SelectionUnconfounded, double-blind, randomised trials of selegiline compared with placebo reported before 31 December 1998. Data ExtractionThe reviewers selected trials for inclusion. Individual patient data were sought, but when these could not be retrieved summary data were extracted from published papers. ResultsOf 27 identified trials, 14 met the inclusion criteria. Individual patient data were retrieved from eight trials on 821 patients. Summary data were extracted from five trials on 240 patients. No data were available from one trial on 12 patients, which was therefore excluded from the meta-analysis. Fixed and random effects meta-analyses were performed on standardised mean differences. For cognition there was a statistically significant difference between selegiline and placebo at 4–6 weeks and 8–17 weeks after randomisation (at 8–17 weeks: smd=0.45 [95% confidence interval 0.03 to 0.88]), but this disappeared at later assessments. The size of the treatment difference was considered unlikely to be of clinical importance. Although there was a statistically significant difference at 4–6 weeks for activities of daily living, this disappeared at later assessments (at 8–17 weeks: smd=0.33 [-0.33, 0.69]). There were no statistically significant differences or clinically relevant differences between selegiline and placebo in terms of emotional state or global response. ConclusionAlthough there was some evidence of improvement with selegiline in the short term in cognition and activities of daily living, the magnitude of the effect did not reach clinical importance. There was no evidence of long term effects. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BackgroundHealth related quality of life scales have been developed to measure a global picture of health and well-being from the patient's perspective. Separate validation of these measures in older people is important, as different areas of life are prioritized as important in older people and population norms for health status measures can differ with age. ObjectivesThe aims of this paper were to examine the validity and acceptability of two health status measures the 12-item Health Status Questionnaire (HSQ-12) and 12-item Short Form Health Survey SF-12, and to present population norms in older people. SettingA door-to-door survey in Islington, a borough of inner London. Subjects and methodsThe subjects were allocated to complete either the SF-12 (n = 541) or the HSQ-12 (n = 544) by alternating the questionnaires with each household visited. The first 135 people who completed the HSQ-12 were visited approximately 18 months later. Acceptability was measured examining the completion rate of the scales, and on a three-point scale. The short-CARE was used to elicit psychiatric symptoms and diagnoses. We collected data on health and social care, and subjective health problems. ResultsBoth scales distinguished between subjects with and without a variety of health states, including self-defined health problems, health problems diagnosed by valid scales, problems with vision and hearing, and receipt of health or social services. The HSQ-12, but not the SF-12, could distinguish between people with and without dementia, and had high completion rates for those living in the community but not in 24-hour care. Linear regression models demonstrated sensitivity to change in health status for the HSQ-12. ConclusionThe SF-12 and HSQ-12 are acceptable and valid as health status instruments in large community-based studies of older people. The HSQ-12, but not the SF-12, is acceptable and valid for people with dementia. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Cobalamin/folate deficiency is common in elderly subjects and may lead to psychiatric symptoms, but even more often it increases the severity of other organic and non-organic mental diseases. This paper reviews the literature relevant for markers of cobalamin/folate status and their relation to neuropsychiatric symptoms in the elderly. Plasma homocysteine, a marker of cobalamin/folate status, is frequently increased in psychogeriatric patients. Among markers of cobalamin/folate status, plasma homocysteine shows the best association with neuropsychiatric dysfunction. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Studies of the primary care treatment of depressed elderly patients are constrained by limited time and space and by subject burden. Research assessments must balance these constraints with the need for obtaining clinically meaningful information. Due to the wide-ranging impact of depression, assessments should also focus on suicidality, hopelessness, substance abuse, anxiety, cognitive functioning, medical comorbidity, functional disability, social support, personality, service use and satisfaction with services. This paper describes considerations concerning the assessment selection process for primary care studies, using the PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial) study as an example. Strategies are discussed for ensuring that data are complete, valid and reliable. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Dementia is a degenerating illness and the lack of a reliable measure of self-report in particular presents particular difficulties for research. Often in the later stages of dementia behavioural measurement is the only tool available for the evaluation of treatment techniques. This paper describes and evaluates a short observational tool suitable for clinical assessment purposes. The scale has been shown to have the potential for adequate inter-rater reliability, test retest reliability, and convergent and divergent validity, if the study limitations reflecting statistical rather than ecological validity, and limitations of sample size are borne in mind. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The association between Down's syndrome (DS) and Alzheimer's disease is well established. This paper presents a review of the literature, suggesting a possible association between DS and the more recently recognised dementia with Lewy bodies (DLB). Patients with DLB frequently present with changes in affect and behaviour, and in particular with psychotic symptoms. The literature suggests a possible role for atypical neuroleptics in the management of psychosis in DLB. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background There are few studies evaluating treatment in gerontopsychiatric day-clinics. In this paper, data are presented on the outcome of day-clinic treatment in late-life depression. Method Forty-four depressed elderly patients (mean Hamilton Depression Score: 17.6) were examined at admission and discharge for psychopathology, functioning in daily living, social situation, burden with medical disease and quality of life. Results At discharge, the patients showed a significant reduction in depressive symptoms, improvements in cognitive performance, social activities and contacts. However, a more detailed analysis revealed that only patients responding to treatment (n =20) improved in the respective parameters. Patients, who did not recover fully from depression (n =24), did not improve in any of these parameters. At admission, responders and nonresponders did not differ concerning quality of life. At discharge, responders were significantly more satisfied in 11 of 20 domains of life quality. A shorter life time duration of depressive disease and male sex were predictive for a remission of depression. Thus, it could be shown that a considerable number of patients suffering from late-life depression may be successfully treated in a gerontopsychiatric day-clinic and 45.5% fully recover from depression. Conclusions The day-clinic setting meets the specific needs of patients suffering from late-life depression by maintaining them in the community, supporting their abilities for self-care and promoting social contacts. Treatment in a day-clinic may be recommended for many elderly depressed patients. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Epidemiological and neuropathological series have identified three predominant dementing processes; Alzheimer's disease (AD), vascular dementia (VaD) and dementia associated with Lewy bodies (termed Parkinson's disease dementia (PDD) in this paper). While each has its own distinguishing features and by definition all impact upon day to day functioning, no random community derived sample has examined clinical features as defined by gait and balance abnormalities and compared disability ratings of the three dementias simultaneously. Six hundred and forty-seven community dwelling subjects participated in the Sydney Older Persons Study and of these 537 participated in a medical assessment. Of these 537,482 informants rated disability. Gait and balance abnormalities of the three major dementias were identified and the association of the dementias with disability examined. The three major dementias showed evidence of both slowing and ataxia in gait and balance tests. This was maximal in those with PDD. Similarly, all showed evidence of disability that was maximal in those with PDD. In conclusion, this study has identified that gait abnormalities are present in all three dementias to a varying degree. It is hypothesised that the varying levels of disability observed are a consequence of the varying levels of motor impairment, resulting in greater levels of disability in those with PDD. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The specific symptoms of depression associated with increased mortality in the depressed elderly are poorly known. The aim of this paper is to analyse the individual depressive symptoms measured by the Zung Self Rated Depression Scale (ZSDS) and the Hamilton Rating Scale for Depression (HRSD) in association with mortality among depressed elderly subjects. The population consisted of 169 depressed (DSM-III criteria) aged (65+ years) persons from a Finnish epidemiological research project. The follow-up for deaths continued for about 6 years. When age, sex, smoking, physical health and functional abilities were taken into account, dissatisfaction, weight loss and gastrointestinal symptoms (anorexia and constipation) predicted mortality together with high age and poor physical health. Weight loss was related to an increased risk of death, specifically in the depressed. Dissatisfaction and gastrointestinal symptoms were more general markers of increased mortality. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There is little information on dementia research in China in the international literature. This paper is an overview of studies on dementia conducted in China. Studies on dementia research in China were identified through a literature search, as well as through consulting Chinese psychiatrists and neurologists with expertise in the field. These studies were then reviewed. Epidemiological studies on dementia in China find the rates of dementia at the lower end of rates in Caucasians. There seems to be regional variation in the ratio of vascular dementia to Alzheimer's disease in China. In addition to epidemiological studies, there are studies on the genetics, psychopathology, neurophysiology and drug treatment in dementia. There is much research activity in China in the field of dementia and further cross-cultural studies are useful to examine the cultural differences in various areas of dementia research. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The objective of this study was to review outcomes of acute service delivery in old age psychiatry. Sources of data included Medline, PsycINFO and Cochrane Collaboration databases of English language papers to 1998 on service delivery evaluation in ‘old age psychiatry’, ‘psychogeriatrics’ and ‘geriatric psychiatry’, supplemented by a manual search of references from relevant literature. All controlled trials, audits, and surveys of the outcomes of service delivery in old age psychiatry located in acute hospitals and community settings were included. Service delivery by medical, adult psychiatry and consultation/liaison services were included. With the exception of outreach services to nursing homes, long term institutional care was excluded. All data were extracted by the author. Data quality was assessed by applying an evidence hierarchy. Evaluation strategies were qualitatively reviewed. Controlled trials, audits and surveys were each found to provide important data in the evaluation of service delivery. There is better quality evidence to support the effectiveness of components of old age psychiatry services than other service types. The majority of studies indicate that old age psychiatry services have positive acute treatment outcomes, particularly with depression. There is insufficient evidence to determine which processes of care are associated with better outcomes. Pluralistic evaluations indicate that carers often have unmet needs and are not as positive about outcomes. There have been no controlled comparisons of service delivery provided by other services. In conclusion, controlled trials and audits indicate that old age psychiatry services are effective. Further pluralistic evaluations and comparisons with other services are required. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The subject of alcoholism in late life has received relatively little attention in the literature. This is despite the fact that elderly people are particularly vulnerable to the adverse effects of alcohol. Demographic data predicts that in the first half of the next century there will be an increase in the absolute number of elderly people with alcohol problems. The recognition and treatment of alcohol problems are likely therefore to become more important as this population expands. High rates of comorbidity with physical and psychiatric illness mean that elderly alcoholics are liable to be frequent users of health facilities. Concern has been expressed regarding the impact this trend will have upon health services, particularly the high costs of treatment and institutionalization. Previous researchers in this field have been disadvantaged by a lack of standardized diagnostic criteria and the absence of age-validated screening tools. This paper reviews recent publications relating to the epidemiology of alcohol problems in the elderly and focuses on comparing the prevalence rates of alcohol problems in various clinical settings. Epidemiological research is important as it improves the understanding of the scope and impact of a disease as well as being a vital component during the planning stage for new services. This review highlights some ongoing limitations in recent research. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There are no clear comprehensive guidelines on risk assessment with the elderly. This paper reviews the literature relevant to the subject in conjunction with the case history of a patient with dementia who committed homicide whilst in residential care. Suggestions concerning factors to be taken into consideration during risk assessment are made. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The ten-point clock test is administered by tracing an 11·4 cm (4 1/2 inch) diameter circle on a piece of paper and asking the patient to ‘Write the numbers in the face of a clock’. The patient is then asked to ‘Make the clock say 10 minutes after 11’. The spacing of the numbers and the positions of the hands are used to score the test. A score of less than eight points identified 71% of patients with Alzheimer's disease who had a Mini-Mental State Examination score of greater than 23. The specificity measured in elderly controls was 82%. The test may prove useful in screening for early stage Alzheimer's disease. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The aim of the case ascertainment for the study was to identify as near complete as possible a population of patients with presenile dementia who had been identified by hospital contact within a defined period of time, and who were currently alive, in the Lothian area. It did not aim to establish epidemiological figures. The Lothian Psychiatric Case Register was the main source of case identification. Case notes were inspected and cases identified for the study. Patients were either in long-term care or at home. As described in Paper I, Age range 30-65 years. Various diagnostic codings, including those of the ICD-9 were used to identify cases from the register. Feighner criteria were applied on case note inspection and DSM-III-R criteria after individuals had been seen. A potential of 557 cases were identified from the case register, etc. Of these, 431 were excluded and 126 seen for the study. The criteria used for inclusion and exclusion of cases in this study are thus directed towards achieving the aims of this study, and the findings would have to be modified to reach an estimate of all cases of early-onset dementia in the Lothian area. [ABSTRACT FROM AUTHOR]

Objective The aim of the case ascertainment for the study was to identify as near complete as possible a population of patients with presenile dementia who had been identified by hospital contact within a defined period of time, and who were currently alive, in the Lothian area. It did not aim to establish epidemiological figures. Design The Lothian Psychiatric Case Register was the main source of case identification. Case notes were inspected and cases identified for the study. Setting Patients were either in long-term care or at home. Patients As described in Paper I. Age range 30–65 years. Measures Various diagnostic codings, including those of the ICD-9 were used to identify cases from the register. Feighner criteria were applied on case note inspection and DSM-III-R criteria after individuals had been seen. Results A potential of 557 cases were identified from the case register, etc. Of these, 431 were excluded and 126 seen for the study. Conclusions The criteria used for inclusion and exclusion of cases in this study are thus directed towards achieving the aims of this study, and the findings would have to be modified to reach an estimate of all cases of early-onset dementia in the Lothian area. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Currently, 1.2 million full-time equivalent employees (FTEs) care for more than 1.5 million residents in nursing homes where 75% of residents have dementia. By the year 2010, the number of residents in these institutions may double. Registered nurses (RNs) make up less than 7% of a home's total FTEs. In contrast, certified nursing assistants (CNAs) account for more than 40% of total FTEs. Thus, CNAs serve as the primary caregivers in nursing homes. Typically, CNAs have a high school education or less, and receive little more than minimum wage. Their extensive contact with residents has a tremendous impact on quality of life, but significant barriers limit their caregiving effectiveness. These barriers include poor pay, minimal long-term benefits, and insufficient training, recognition and support for their physically and emotionally labor-intensive care. This paper addresses the issues of training CNAs for dementia care by suggesting an organizational framework within which to view dementia training; providing an overview of barriers to empowering CNAs to provide quality care to dementia residents; reviewing research that has addressed a specific barrier; making recommendations for future research; and suggesting research approaches to address these recommendations. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

As we approach the next century, it is clear that neither formal services nor informal family caregivers can meet the needs of a growing population. It is therefore pertinent to reconceptualize the linkages between formal and informal care and move towards an integrative model. This paper explores several models of such an interface that exist in the literature and proposes that many of these overlap. Various predictors of formal service use are also explored, with an emphasis on the outcomes of both the informal caregiver and the care recipient. Implications for future research include further exploring and understanding the link between formal and informal support and the need to increase receipt of formal care among family caregivers. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Assessment was identified as one of the ‘cornerstones’ of community care. This study presents findings from the first nationally representative analysis of assessment documents used by social services agencies in the UK. Method In this paper analysis is made of 50 assessment documents used for the ‘comprehensive’ assessment of older people. The documents were examined in the extent to which they covered 33 assessment domains, grouped into four areas: functional domains; cognitive, mood and psychosocial domains; social environment domains; and clinico-medical domains. The documents were analysed on three dimensions: whether the domains were covered at all; whether the domain was covered in sufficient detail; and whether it would elicit a structured response. Results Activities of daily living were covered to some extent on the majority of documents, as were the instrumental activities of daily living. Very few documents were designed to elicit information on the potential for rehabilitation. Whilst the majority of forms were designed to collect some information on cognitive patterns, mood state and social activity, very few were designed to collect this in any detail. Although functional activities of daily living were covered in greater detail than the other domains overall, there was enormous variability between the documents, thus hampering their ability to generate any standardized information. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper reviews the research evidence relating to non-pharmacological interventions with people with dementia aiming to improve well-being and independence. There have been a number of attempts to improve the person's level of independent functioning through programmes training and supporting self-care skills, mobility, continence, orientation and participation in activities. Well-being has been less often directly addressed, although recently studies have begun to specifically target aspects of it. Increased independence does not necessarily lead to greater well-being, and it is clear that the greatest potential for increasing function is in tackling the excess disability which many care giving situations in effect impose on the person with dementia. In carrying out research in this area, the limitations of randomized controlled trials are evident, and there is much to be said for the reporting of series of carefully controlled single-case studies in addition to group studies. Further development of methods of measuring well-being in people with dementia is also required. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper addresses four questions concerning family training in dementia care: (1) What do we know about what works? (2) How do we know it? (3) What do we now need to know? (4) How should we go about trying to find this out? In addition, it provides some introductory information on the nature of family caregivers in dementia and the phenomenology of caregiver burden and behavioral problems in dementia, often the focus of family training. Training families to provide care to dementia patients has a long clinical history. In recent years, the amount and popularity of this kind of information has grown exponentially, as is evident in the proliferation of books, training materials and informational handouts. Even video and world wide web technology is now used to educate caregivers. Over a decade ago, reports showed that caregivers were able to learn specific behavioral techniques and successfully reduce problematic behaviors. More recently, controlled trials have suggested the effectiveness of caregiver training programs in reducing behavioral problems or delaying institutionalization in patients with dementia. There is much still unknown concerning family training in dementia care. Additional controlled clinical trials are needed, as are additional studies to understand the broader factors known to influence effective care, such as patient and caregiver physical health or family and social supports. Copyright © 1999 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The contribution of Sir Aubrey Lewis (1900–1975) to the field of old age psychiatry is recognized by the presentation of his 1946 paper in the Journal of Mental Science . © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper was one of the first demonstrations of a correlation between neurochemical cholinergic abnormalities, senile plaque neuropathology and mental test scores in senile dementia. Subjects were drawn from hospital patients in an acute medical ward or a psychogeriatric department 13 were normal, to were depressed and 28 suffered from dementia. Neuropathological examination consisted of senile plaque counts in the neocortex, number of cells affected by granulovacuolar degeneration in the hippocampus and the severity and distribution of neurofIbrillary tangles and in the neocortex.

This article presents a list of research papers published in different journals related to geriatric psychiatry. Some of them are, "Cognitive Therapy for Depression in the Elderly," "The Amyloid Peptide Precursor in Alzheimer's Disease," "The Oldest Old and Personal Activities of Daily Living," "Aging Mothers and Their Daughters Perceptions of Conflict Behaviors," "Psychological Impact of Illness Downturns: A Comparison of New and Chronic Conditions," "Measuring Quality of Life Among the Elderly in Developing Countries," "Major and Minor Depression in Later Life: A Study of Prevalence and Risk Factors."

This article presents a list of research papers published in different journals on geriatric psychiatry. Some of them are, "Neuropsychological Issues in Lewy Body Disease and Related Disorders"; "Psychotic Symptoms in Patients With Dementia"; "Making the Diagnosis and Treatment of Alzheimer's Disease"; "Depression in Old Age: Is There a Real Decrease in Prevalence? A Review"; "Changing Characteristics of Psychiatrists Who Heat Geriatric Patients"; "Inhibitory Processes in Young and Older Adults in a Picture Word Task"; "Aging and Mental Retardation"; "Elder Abuse: An Overview of Recent and Current Developments."

The country/region of origin of all original papers appearing in the International Journal of Psychiatry (IJGP) during the first 9 years of its publication was recorded. A inure detailed analysis of citation patterns was carried out on the 105 original articles published during 1992. The results indicated that 50-60% of the articles emanated from the United Kingdom but that in general authors cited a broad range of specialities from journals published around the world. North American authors tended to cite North American sources more frequently titan did their counterparts from other countries. There was evidence that the impact of the IJGP is increasing despite its omission from same scientific reference databases. [ABSTRACT FROM AUTHOR]

The article presents a list of books, conferences and research papers related to geriatric psychiatry, published in various journals. Some of the books are: "Localized Cerebral Atrophy: An Important Cause of Non-Alzheimer's Dementia," by R.C. Baldwin; "Complete Loss in Old Age: An Analysis of the Literature on Activities of Daily Living and Care Needs," by H.W. Wahl; "Memory for Relevant and Irrelevant Information in Old Age," by O. Ewert and M. Martin.

One hundred and sixty-nine people over the age of 65 receiving home care services in Lewisham were interviewed using the Geriatric Mental State (A) (GMS(A)) and diagnostic output was obtained using AGECAT. The prevalence of psychiatric disorder in this group is reported and is compared with that found in community surveys which have used the GMS/AGECAT package. Of note is the 26.0% prevalence rate of cases of depression. The prevalence rate of AGECAT ‘depressive psychosis’ was found to be 13.6%, which was significantly higher than expected. Measures of agreement between AGECAT diagnostic cases and assessments made by home care staff are presented—‘kappa’ values and negative predictive values are higher for organic cases than for cases of depression. These ‘recognition’ rates are compared with reported recognition rates of psychiatric disorder in the elderly by health care professionals. Suggestions for further research are made so that the stated alms of the White Paper Caring for People can be achieved. [ABSTRACT FROM AUTHOR]

The article comments on a paper by R. Sanchez-Arenas and colleagues that was published in the "International Journal of Geriatric Psychiatry" which talks about the reliability of EQ-5D-3L. The article argues that the authors of the paper were not able to show how they have determined the reliability of the whole measurement instrument. Also mentioned is the approach called Cronbach's alpha.

Background Inefficient civil registration systems, non-report of deaths, variable standards in certifying death and the legal and social consequences of suicide are major obstacles in investigating suicide in the developing world. Very high rates of suicide have been recorded in the region in the general population and among younger people. Objective This paper describes the suicide rate among the elderly in Kaniyambadi block, Tamil Nadu, South India for the years 1994–2002 using verbal autopsies. Method The setting for the study was a comprehensive community health program in a development block in rural South India. The main outcome measure was death by suicide diagnosed by a detailed verbal autopsy and census, birth and death data to identify the population base. Results The average annual suicide rate was 189 per 100,000 for people over 55 years of age. The ratio of male to female suicides was 1: 0.66. The age-specific suicide rate for men and women increased with age. Hanging (52%) and poisoning with organo-phosphorus compounds (39%) were the commonest methods employed for committing suicide. Significantly more women chose drowning or burning than men who preferred poisoning or hanging (χ2 19.75; df 1; p < 0.001). Conclusions The suicide rate documented in this study among the elderly is very high. The reasons for the high suicide rate observed in older people are not known. There is a need to develop innovative strategies to reduce deaths by suicide. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Diogenes syndrome (DS) is characterized by extreme self-neglect, domestic squalor, and social withdrawal. Despite having been described decades ago, it is still difficult to persue a correct diagnosis in primary care clinics. Methods This paper reports a case of an elderly man with extreme self neglect and an abnormal collecting pattern whose condition remained undetected for many years. His collectionism was manifested with a tendency to store items in an organized manner but without a clear purpose. Conclusion The authors suggest that the presence of collectionism could be a helpful clue towards diagnosis of DS in similar cases. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Although Alzheimer is best known for the disease which bears his name and which was given its eponymous title by Kraepelin (1910), he established his reputation on his work on arteriosclerotic dementia; about which he wrote very extensively (1895, 1897, 1898, 1902, 1913). This early paper on the top is concise and lacks the extensive, repetitive and extremely detailed neuropathological descriptions which are features of many others. Both in this paper and elsewhere, Alzheimer shows striking originality which is usually associated with modesty and generous attributions of primacy to those who may have described what he is writing about before him. This paper is naturally marked by the preoccupation with the separation of arteriosclerotic dementia from general paralysis of the insane since he was writing at a time when syphilis was probably the commonest cause of dementia. He shared the concerns and aims of Binswanger (1894), whose name is now associated with subcortical vascular disease. Both here and in his later publications, Alzheimer gave clear clinical guidelines which might allow his contemporaries to distinguish vascular dementia from general paralysis and senile dementia. The paper was presented at the yearly congress of the Society of German Alienists in Dresden in 1894 and published in the Allgemeine Zeitschift für Psychiatric (1895). Alzheimer's style of writing is at times ponderous, opaque and repititive. We have attempted to preserve as much as possible of the text's flavour while trying to make it comprehensible. We hope that it will draw some attention to Alzheimer's importance in the evolution of the concept of vascular dementia. [ABSTRACT FROM AUTHOR]

This article presents a commentary on dementia. The association of ante-mortem clinical data with post-mortem findings in dementia began in Newcastle with this amongst a series of classic papers on the subject. For the first time researchers presented evidence, linking the classical pathological hallmarks of Alzheimer's disease (AD), plaques and tangles with the 'core' clinical feature of cognitive decline, and decrease in everyday living skills. The Newcastle group recognized that neither plaques nor tangles were pathognomic of AD being present to a lesser extent in normal ageing.

The article presents information related to a key paper by professor Elaine Murphy on "The Social Origins of Depression in Old Age." Professor Murphy modestly suggests that her early work was a product of necessity and perhaps even expedience since she used the intellectual and material resources available to her at that time. While this may reflect the logistic aspects of her research, Professor Murphy obviously underestimates the vision, the creativity and the clear thinking that made a classic out of a junior psychiatrist's thesis. After all the success of clinical research, like that of most other scientific products, depends to a large extent on how well it is part of the social and intellectual zeitgeist.

This commentary was inadvertently omitted from the Key Paper ‘Pernicious Anaemia and Reversible Dementia: Strachan and Henderson 30 Years Later’ by Peter Rabins, published in Volume 13 Issue 3, pages 139-140 (1998). [ABSTRACT FROM AUTHOR]

The cover image is based on the Special Issue Paper I Effectiveness of DementiAbility Methods: The Montessori Way™ on agitation in long term care home residents with dementia in Hong Kong i by Ivo Yuen et al., https://doi.org/10.1002/gps.5063. GRAPH. [Extracted from the article]

The original article to which this Erratum refers was published in the International Journal of Geriatric Psychiatry 15(3) 2000, 201–202. Following publication of the above paper in the March 2000 edition of the International Journal of Geriatric Psychiatry (15 (3), 201–202), it came to our attention that one of the co-authors names was omitted from the contents page. The authors of this paper are Dr Seena Fazel and Professor Robin Jacoby. The publishers would like to apologise for any confusion caused. Copyright © 2000 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article introduces the April 1996 issue of the "International Journal of Geriatric Psychiatry." This special edition of the journal celebrates the contribution of Academician Raymond Levy to academic old age psychiatry by a series of invited research papers whose authors were stimulated into and supervised through their own research areas by Raymond. The research papers are presented in the approximate chronological order in which their authors worked with Raymond. The range of topics covered in this volume reflects the eclecticism of Raymond's research interests over the past two decades.

The article discusses the use of the Mini Mental State Examination (MMSE) for the detection of early dementia. According to the author, MMSE is the most widely used cognitive screening test developed for the evaluation of the cognitive status of elderly people in clinical settings. Results of a meta-analysis of 13 research papers reporting direct comparisons of the MMSE with either the Modified Mental State Examination (3M/MMMSE) or the Addenbrooke’s Cognitive Examination (ACE) are presented.

I am not a specialist—I am simply a carer who not long ago did not even know that there was such an affliction as Alzheimer’s disease. I have been looking after my mother, who has dementia, for eight years and working part-time whenever a nurse was available. In this paper I want to share my experiences of caring in Poland and describe the growth of our local support organisations. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Editors Note : This editorial and the subsequent three papers, ‘Alzheimer's Disease in Poland’, ‘Sexual Expression and Dementia’ and ‘Prevalence of Dementia in a Rural Setting: A Report from India’, reflect the output of the 1994 Xth Alzheimer's Disease International meeting in Edinburgh in 1994, emphasizing the international experience of the disorder in self-help groups in Eastern Europe, difficulties of epidemiological studies in India and the complex interplay between staff attitude and residents' sexuality in nursing homes in the USA. © 1997 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Presents an overview of the articles found in the 1991 issue of the journal "International Journal of Geriatic Pscychiatry." Reason for the relative neglect of affective disorders in old age; Presentation of contributed papers during an advanced course on affective disorders in old age at the Institute of Psychiatry in London; Discussion on the possible relationship between depression in the elderly and cerebral organic change.

The article presents information on various conferences and events related to geriatric psychiatry. There will be a symposium on the subject of affective disorders in old age held by the European Association of Geriatric Psychiatry on October 7-8, 1988 in Amsterdam, Netherlands. Australia is the setting for the Alzheimer's Disease International's important meeting in Brisbane, commencing September 5, 1988. The next issue of "Geriatric Depression" will be devoted to discussion and review papers on aspects of depression in later life.

The article reflects on a study published in a 1992 issue of the "International Journal of Geriatric Psychiatry," concerning partition delusions in late paraphrenia. It highlights the published summary of the study. It explains the motive for writing a paper about partition delusions.

This short paper attempts to provide a framework to aid the old-age psychiatrist in choosing psychotropic drugs in a way that minimizes the risks of adverse drug reactions. It concentrates on the clinical problems most frequently encountered in old-age psychiatric practice. Older people are at risk of adverse drug interactions because of their higher rate of physical morbidity and increased likelihood of receiving polypharmacy, as well as due to age-related change in drug handling. The strongest evidence for relevant interactions in older people relates to changes in renal excretion (particularly relevant for lithium) and cytochrome P450 (relevant for a wide range of psychotropic and other drugs). Awareness of potential interactions is important in ensuring safe prescribing practice for older people with mental health problems. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective Olanzapine (OLZ) is unique among currently available antipsychotic medications in its antagonism of a range of receptor systems including dopamine, norepinephrine, serotonin, acetylcholine, and histamine. Olanzapine's mechanistic complexity provides a broad efficacy profile in patients with schizophrenia and acute, pure or mixed mania. Patients experience symptomatic relief of mania, anxiety, hallucinations, delusions, and agitation/aggression and reduced depressive, negative, and some cognitive symptoms. This paper will review the safety profile of OLZ, focusing on the elderly, where data are available. Method Preclinical and clinical studies of OLZ are reviewed, with emphasis on its possible effects on the cholinergic system and the histamine H[sub 1] receptor. Weight change and related metabolic considerations, cardiac and cardiovascular safety, and motor function during treatment with OLZ are also reviewed. Results and Conclusion In vitro receptor characterization methods, when done using physiologically relevant conditions allow accurate prediction of the relatively low rate of anticholinergic-like adverse events, extrapyramidal symptoms, and cardiovascular adverse events during treatment with OLZ. Currently available clinical data suggest olanzapine is predictably safe in treating adult patients of any age with schizophrenia and acute bipolar mania, as well as in treatment of patients with some types of neurodegenerative disorders. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Provides information on scientific papers on social gerontology for the International Committee of Social Gerontology.

This is a report of a clinical case presentation from the Neuropsychiatry Conference held at Fulbourn Hospital, Cambridge on March 13, 1992. The conference, chaired by Dr Nigel Hymas, was asked to comment on the diagnosis of a case first referred during September 1990. A 60-year-old man with no previous history of psychiatric illness presented with persecutory ideation, delusions and hallucinations in the absence of cognitive impairment. At the time, the initial tentative psychiatric diagnosis was one of late paraphrenia, but it later became clear that the patient was dementing. Were the paraphrenia and dementia related? If so, how? What was the nature of the dementing illness? Could life-long personality abnormalities have been the earliest expression of cerebral abnormalities predisposing him to his current illness? Incompatible evidence from clinical features, functional brain scanning and comprehensive neuropsychological testing demonstrates the inadequacy of current diagnostic criteria. [ABSTRACT FROM AUTHOR]