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Development and validation of a geriatric depression screening scale: A preliminary report

Biochemical, electrophysiological, and pharmacological evidence supporting a role for cholinergic dysfunction in age-related memory disturbances is critically reviewed. An attempt has been made to identify pseudoissues, resolve certain controversies, and clarify misconceptions that have occurred in the literature. Significant cholinergic dysfunctions occur in the aged and demented central nervous system, relationships between these changes and loss of memory exist, similar memory deficits can be artificially induced by blocking cholinergic mechanisms in young subjects, and under certain tightly controlled conditions reliable memory improvements in aged subjects can be achieved after cholinergic stimulation. Conventional attempts to reduce memory impairments in clinical trials hav not been therapeutically successful, however. Possible explanations for these disappointments are given and directions for future laboratory and clinical studies are suggested.

https://science.sciencemag.org/content/sci/217/4558/408.full.pdf

The Cholinergic Hypothesis of Geriatric Memory Dysfunction

A Treatise on the Family. G. S. Becker. Cambridge, MA: Harvard University Press. 1981. Gary Becker is one of the most famous and influential economists of the second half of the 20th century, a fervent contributor to and expounder of the University of Chicago free-market philosophy, and winner of the 1992 Nobel Prize in economics. Although any book with the word "treatise" in its title is clearly intended to have an impact, one coming from someone as brilliant and controversial as Becker certainly had such a lofty goal. It has received many article-length reviews in several disciplines (Ben-Porath, 1982; Bergmann, 1995; Foster, 1993; Hannan, 1982), which is one measure of its scholarly importance, and yet its impact is, I think, less than it may have initially appeared, especially for scholars with substantive interests in the family. This book is, its title notwithstanding, more about economics and the economic approach to behavior than about the family. In the first sentence of the preface, Becker writes "In this book, I develop an economic or rational choice approach to the family." Lest anyone accuse him of focusing on traditional (i.e., material) economics topics, such as family income, poverty, and labor supply, he immediately emphasizes that those topics are not his focus. "My intent is more ambitious: to analyze marriage, births, divorce, division of labor in households, prestige, and other non-material behavior with the tools and framework developed for material behavior." Indeed, the book includes chapters on many of these issues. One chapter examines the principles of the efficient division of labor in households, three analyze marriage and divorce, three analyze various child-related issues (fertility and intergenerational mobility), and others focus on broader family issues, such as intrafamily resource allocation. His analysis is not, he believes, constrained by time or place. His intention is "to present a comprehensive analysis that is applicable, at least in part, to families in the past as well as the present, in primitive as well as modern societies, and in Eastern as well as Western cultures." His tone is profoundly conservative and utterly skeptical of any constructive role for government programs. There is a clear sense of how much better things were in the old days of a genderbased division of labor and low market-work rates for married women. Indeed, Becker is ready and able to show in Chapter 2 that such a state of affairs was efficient and induced not by market or societal discrimination (although he allows that it might exist) but by small underlying household productivity differences that arise primarily from what he refers to as "complementarities" between caring for young children while carrying another to term. Most family scholars would probably find that an unconvincingly simple explanation for a profound and complex phenomenon. What, then, is the salient contribution of Treatise on the Family? It is not literally the idea that economics could be applied to the nonmarket sector and to family life because Becker had already established that with considerable success and influence. At its core, microeconomics is simple, characterized by a belief in the importance of prices and markets, the role of self-interested or rational behavior, and, somewhat less centrally, the stability of preferences. It was Becker's singular and invaluable contribution to appreciate that the behaviors potentially amenable to the economic approach were not limited to phenomenon with explicit monetary prices and formal markets. Indeed, during the late 1950s and throughout the 1960s, he did undeniably important and pioneering work extending the domain of economics to such topics as labor market discrimination, fertility, crime, human capital, household production, and the allocation of time. Nor is Becker's contribution the detailed analyses themselves. Many of them are, frankly, odd, idiosyncratic, and off-putting. …

A Treatise on the Family

Erik Eriksen is a remarkable individual. He has no college degrees yet is Professor of Human Development at Harvard University. He came to psychology via art, which explains why the reader will find him painting contexts and backgrounds rather than stating dull facts and concepts. He has been a training psychoanalyst for many years as well as a perceptive observer of cultural and social settings and their effect on growing up. This is not just a book on childhood. It is a panorama of our society. Anxiety in young children, apathy in American Indians, confusion in veterans of war, and arrogance in young Nazis are scrutinized under the psychoanalytic magnifying glass. The material is well written and devoid of technical jargon. The theme of the volume is that it is human to have a long childhood which will leave a lifelong residue of emotional immaturity in man. Primitive groups and

Childhood and Society.

/pdf/relatives-of-the-impaired-elderly-correlates-of-feelings-of-3yz6hqn7n8.pdf

Relatives of the Impaired Elderly: Correlates of Feelings of Burden

Subjective Burden of Husbands and Wives as Caregivers: A Longitudinal Study

The Revised Memory and Behavior Problems Checklist (RMBPC), a 24-item, caregiver-report measure of observable behavioral problems in dementia patients, provides 1 total score and 3 subscale scores for patient problems (memory-related, depression, and disruptive behaviors) and parallel scores for caregiver reaction. Data were obtained from 201 geriatric patients and their caregivers. Factor analysis confirmed 3 first-order factors, consistent with subscales just named, and 1 general factor of behavioral disturbance. Overall scale reliability was good, with alphas of .84 for patient behavior and .90 for caregiver reaction. Subscale alphas ranged from .67 to .89. Validity was confirmed through comparison of RMBPC scores with well-established indexes of depression, cognitive impairment, and caregiver burden. The RMBPC is recommended as a reliable and valid tool for the clinical and empirical assessment of behavior problems in dementia patients. The need for a brief, conceptually and psychometrically sound method for assessing behavioral problems in patients with dementia is clear. Behavioral problems and dementia are inexorably linked; indeed, dementia can scarcely be discussed without significant attention to the pervasive and complex behavioral problems that accompany it. Early writings first pointed to the role of such problems in diagnosis and management (Alzheimer, 1907), and numerous clinical reports have detailed the prevalence and diversity of such problems (e.g.,

Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist.

An invaluable resource guide for anyone working with persons suffering from Alzheimer's disease, this is the first book to present a step-by-step program to help families cope with the day-to-day problems arising from this disease. Using detailed case examples, the authors offer unique and effective strategies to help the family--and the patient--have enjoyable and more productive lives. "Well written and eminently practical guide for families struggling with the burdens of Alzheimer's disease." --Peter V. Rabins, M.D., John Hopkins University School of Medicine, author of Thirty-Six Hour Day "An outstanding book dealing knowledgeably and sensitively with a painful disease affecting millions of American familes." --Robert N. Butler, M.D., Brookdale Professor of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York

The Hidden Victims of Alzheimer's Disease: Families Under Stress

To clarify the role of memory impairment in the aged as a normal or psychopathological phenomenon, 153 persons 50-years-old and over with varying degrees of depression and altered brain function were compared for their complaints about memory and actual performance on a series of memory tests. It was found that while performance varied with altered brain function, complaint was related to level of depression, regardless of performance. Exaggerated memory complaint was considered one manifestation of a general pattern of discrepant reporting of symptoms by depressed persons, and apparently related to an underlying personality factor. The complaint of superiority of remote over recent memory was not substantiated empirically, but was considered part of the pattern of stereotyped language and attitudes characteristic of depressed persons.

Steven H. Zarit

Papers

Relatives of the Impaired Elderly: Correlates of Feelings of Burden

Subjective Burden of Husbands and Wives as Caregivers: A Longitudinal Study

Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist.

The Hidden Victims of Alzheimer's Disease: Families Under Stress

Memory complaint and impairment in the aged. The effect of depression and altered brain function.