Showing papers on "Cognitive decline published in 1987"

Factors affecting intellectual outcome in pediatric brain tumor patients

Abstract: A prospective study utilizing repeated intellectual testing was undertaken in 73 children with brain tumors consecutively admitted to Childrens Hospital of Los Angeles over a 3-year period to determine the effect of tumor location, extent of surgical resection, hydrocephalus, age of the child, radiation therapy, and chemotherapy on cognitive outcome. Forty-three patients were followed for at least two sequential intellectual assessments and provide the data for this study. Children with hemispheric tumors had the most general cognitive impairment. The degree of tumor resection, adequately treated hydrocephalus, and chemotherapy had no bearing on intellectual outcome. Age of the child affected outcome mainly as it related to radiation. Whole brain radiation therapy was associated with cognitive decline. This was especially true in children below 7 years of age, who experienced a very significant loss of function after whole brain radiation therapy.

Age and diabetes related changes in verbal fluency

Abstract: Non-insulin-dependent diabetes mellitus is present in 7-10% of the aged. This disease appears to be associated with an acceleration of the aging process and results in compromised performance on learning and memory tasks. The present study used a verbal fluency test to examine semantic memory performance in two age groups (55-64 and 65-74 years) of diabetic subjects and controls. In addition, immediate and secondary memory were also examined using the digit symbol and digit span tests and a serial learning task. Results showed that digit symbol performance was poorer for older subjects and diabetics while serial learning was poorer only for diabetic subjects. However, the number of words generated on the verbal fluency test was similar for all groups. Qualitative analyses of the verbal output revealed that older subjects and diabetics produced the greatest number of previously recited words (repetitions). Repetitions may signal a failure to adequately monitor behavior which in turn could contribute to cognitive decline.

O-substituted tetrahydropyridine oxime cholinergic agents

Abstract: Certain O-substituted-1,2,5,6-tetrahydro-3- or 1,2,3,6-tetrahydro-4-pyridine oximes are useful as agents for treating pain or for treating the symptoms of senile cognitive decline.

Free Recall and Word Finding Ability in Normal Aging and Senile Dementia of the Alzheimer's Type: the Effect of Item Concreteness

Abstract: This study examined the effect of item concreteness on free recall and word finding ability in three groups: young adults, normal old adults, and individuals with senile dementia of the Alzheimer's type (SDAT). The results of Experiment 1 showed, in addition to an overall decline in recall across the three groups, an attenuation with normal aging of the memory advantage of concrete over abstract words. The SDAT group, however, did not show this attenuation. Experiment 2 compared word finding ability for concrete and abstract items. Word finding was significantly impaired in SDAT but not in normal aging. Furthermore, the SDAT group did much worse on the abstract items. This difficulty with the retrieval of abstract words can explain the unexpected concreteness effect in the SDAT group in Experiment 1. The attenuation of the concreteness effect was predicted on the basis of the communication hypothesis of age-related cognitive decline, which attributes age deficits to a breakdown of the memory network. The results are consistent with the reduced activation of information in this network.

Quantitative CT analysis of brain morphometry in adult Down's syndrome at different ages

Abstract: Quantitative CT demonstrated that healthy adults with Down9s syndrome (DS) have smaller brains and smaller intracranial volumes than controls. Normalized volumes of CSF, ventricles, and brain parenchyma did not differ in patients and controls. Both DS subjects and controls showed similar significant age-related increments in volumes of CSF and ventricles. Of seven older DS subjects, one was demented, whereas the group as a whole showed reductions in cognitive test scores as compared with younger DS subjects. The results demonstrate cognitive decline in older DS subjects, but no brain atrophy other than that expected with aging.

Comparison of the sensitivity of three instruments for the detection of cognitive decline in elderly living at home.

Abstract: We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS] were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.

Depression, anxiety, paranoid reactions, hypochondriasis, and cognitive decline of later-life inpatients.

Abstract: The relationships among the psychopathological states of depression, anxiety, hypochondriasis, paranoid reactions, and cognitive decline for later-life psychiatric inpatients were addressed. The relationship of these variables to life satisfaction, health, pain, and behavior was also considered. Sixty later-life (older than 55 years) psychiatric patients on an acute geropsychiatric unit were administered a battery of psychological scales; Mini Mental State, Beck Depression Inventory (somatic and psychological components), State-Trait Anxiety Scale, MMPI Paranoia scale (and Harris-Lingoes subscales), the Hypochondriasis Scale (Institutional Geriatric), Life Satisfaction Scale-Z, and self-rated pain responses. In addition, these patients were rated on the MACC-Behavioral Adjustment Scale and the Cumulative Illness Rating Scale. Results showed that there is a high degree of interrelationship among the psychopathological variables except cognition. Independent stepwise regression showed that life satisfaction was accounted for by hypochondriasis and anxiety; health, by depression; pain, by hypochondriasis; and behavior, by cognition.

Substituted tetrahydro-3-pyridine-carboxylic acid, ester, and amide cholinergic agents

Abstract: Certain substituted 1,2,3,6-tetrahydro- and 1,2,5,6-tetrahydropyridine-3-carboxylic acids, esters, and amides possessing muscarinic binding activity, having utility for the treatment of the symptoms of senile cognitive decline disclosed. Pharmaceutical compositions and a pharmaceutical method of treatment are also disclosed.

Estimating sample size for longitudinal studies of age-related cognitive decline.

Abstract: Cross-sectional age-group norms for cognitive tests reveal a progressive age-related decline. There is current interest in the possibility of developing interventions that forestall the normal cognitive decline in elderly adults. This raises new research design issues, one of which is the estimation of appropriate sample sizes for longitudinal studies when only cross-sectional data are presently available. Formulae for estimating change parameters from cross-sectional data are presented in this article. Based on age-related changes in cross-sectional norms for the Wechsler Adult Intelligence Scale (WAIS), the sample sizes required for controlled intervention studies of 1 to 3 years duration are very large. If cognitive decline within individuals is not as great as the decline evident in cross-sectional norms, the required sample sizes will be even larger.

Psychiatric aspects of epilepsy.

Abstract: The relationship between epilepsy and psychiatry is reviewed. It is concluded that patients with epilepsy display more psychopathology than control populations and that patients with temporal lobe epilepsy are especially susceptible to more severe psychiatric illness. Psychosis, particularly with a schizophrenia-like presentation seems associated with dominant hemisphere pathology especially with altered function. The relationship between personality disorder and epilepsy is less clear. Affective disorder is a common clinical problem, although earlier reports of a link with the non-dominant hemisphere have not been replicated in some recent studies. The problem of cognitive decline is examined and it is concluded that many patients with epilepsy show either selective or more generalized impairments of abilities. This may be related to the effects of anticonvulsant drugs, and the possibility that carbamazepine may possess psychotropic properties is noted.

Method of treating senile cognitive decline with N'-substituted aminopyridine adrenergic agents

Abstract: A method is disclosed for the treatment or amelioration of the symptoms of cerebral insufficiency characterized by decreased central adrenergic and/or cholinergic function employing certain N-substituted aminopyridines.

Oral health and the patient with dementia

Abstract: SUMMARY Approximately 1.5 million people in the US have Alzheimer's disease. As the older population increases, the number of persons with Alzheimer's disease will also increase. The goal of the dental care provider, for these persons, is to maintain oral health despite a setting of physical and cognitive decline. Providing dental care to patients with a dementing illness will require modification of patient management techniques, particularly a greater use of nonverbal communication and an alteration in verbal communication patterns. Appropriate treatment planning and aggressive prevention are critical to the maintenance of their oral health.

Late-onset paranoid disorder

Abstract: While the onset of paranoid states in the geriatric population has received some attention, recent research results on such proposed etiological factors as sensory impairments, cognitive decline, and pre-existing schizophrenia-spectrum pathologies remain equivocal. The authors present an alternative hypothesis positioning the interaction of pre-existing narcissistic personality features with unique aspects of the aging process. Case studies and innovative treatment strategies are discussed.

Contingent negative variation and reaction time in patients with presenile idiopathic cognitive decline and presenile Alzheimer-type dementia. Preliminary report on long-term nicergoline treatment.

Abstract: Up to date 6 patients with initial presenile idiopathic cognitive decline (PICD) and 5 suffering from a presenile Alzheimer-type dementia (PAD) with a mean age of 59.5 were admitted to the trial. The 6 PICD patients were assigned to a double-blind nicergoline/placebo 6-month course with an oral dose of 30 mg twice a day. PAD patients were treated in an open design (nicergoline oral dose 30 mg twice a day) for at least 6 months. Until now only 4 PICD and 3 PAD patients have been treated regularly for 6 months. Two of 4 PICD patients showed a progressive enhancement of contingent negative variation (CNV), shorter reaction time (RT) and an improvement of clinical status. The other 2 PICD patients, on the contrary, showed a progressive mild worsening of CNV-RT and clinical patterns. The double-blind trial is not yet completed. CNV activity, RTs and clinical patterns progressively improved also in 2 PAD patients while in the 3rd they remained nearly unchanged or minimally worse during the 6-month treatment. The positive nicergoline effect on CNV-RT and clinical status noted in our patients appeared similar to that observed by other authors with DHEMT in patients with senile dementia of Alzheimer type. No adverse drug-related reactions were seen.

Chapter 1 Antipsychotic Agents

Abstract: Publisher Summary The organic pathology underlying chronic schizophrenia, which remains a devastating mental disorder, has emerged as a major topic of discussion. It presents an extremely difficult challenge for the discovery of safe and effective therapeutics. Recent studies, employing positron emission tomography have provided clear evidence of dopamine (DA) receptor proliferation in untreated schizophrenics. This finding may be an important underpinning for the DA hypothesis of schizophrenia, especially in light of the fact that DA antagonists are still the only established pharmacotherapy for psychosis. Nevertheless, anti-psychotic medications leave much to be desired, in terms of both efficacy and side effect profile. Consequently, the search continues for DA antagonists with improved therapeutic ratios as well as novel agents that can attenuate dopaminergic neurotransmission without direct interaction at DA receptors. Neuroleptic drugs are effective against the florid symptoms of psychosis. The benzamide neuroleptics form a distinct class of drugs on the basis of two attributes— that is, structural commonality and selectivity for D 2 DA receptors. Substituted benzamides have exhibited varying propensities to induce extrapyramidal side effects (EPS). Such drugs, for example, metoclopramide, resembles with classical neuroleptics with regard to EPS liability, while remoxipride also being similar in efficacy to classical agents but causes less severe EPS. It is recently observed to be a very selective, low potency D 2 blocker in vitro . Remoxipride preferentially inhibits the binding of [ 3 H]spiperone to DA receptors in limbic regions(rat brain). Striatal DA receptors are blocked only to the extent of 60%, even at very high drug doses. Raclopride possesses very high affinity for D 2 receptors in vitro and binds preferentially to the striatum in the rat in vivo . While neuroleptic drugs are effective against the florid symptoms of psychosis, negative symptoms of schizophrenia, such as social withdrawal and cognitive decline, remain uncontrolled.

Porphyria and psychosis: a case report.

Abstract: This article reports the case of a 41 year old female with a history of acute intermittent porphyria who presented with exacerbation of a chronic psychotic illness. Though the evaluative studies for an acute porphyric episode were negative, psychological testing was consistent with an organic patchy cognitive decline. This finding is discussed in relation to the reported assymetric neuropathic lesions reported in porphyria.

Comparison of rates of progression in Alzheimer's disease and Parkinson's disease

Abstract: In order to compare the progression of memory impairments in Parkinson's disease (PD) and Alzheimer's disease (AD), we administered the Memory and Information section of the Blessed Dementia Scale (BDS) at least twice to 33 patients with PD and 70 with AD. The BDS scores of AD patients deteriorated over time. In contrast, the scores of PD patients were essentially stationary. A substantial difference in rate of cognitive decline persisted upon comparing only those PD and AD patients who showed memory deficits of the same magnitude. The uniform failure to observe cognitive deterioration among PD patients suggests that any PD patients who deteriorate at a rate typical of AD may indeed have AD or a related dementing disorder in addition to the characteristic nigral-striatal degeneration of PD.

Pharmaceutical composition comprising alpha-2I-selective adrenergic receptor agonists and the use thereof in memory enhancement

Abstract: Disclosed is a method of treating memory disorders and cognitive decline, e.g., age-related cognitive decline, in a primate by administering thereto a therapeutically effective amount of an alpha-2 agonist having a high affinity for the alpha-2I subtype, e.g., guanfacine and guanabenz or a nontoxic, pharmaceutically acceptable salt thereof. Particularly preferred is the use of alpha-2I selective agonists such as guanfacine.