Showing papers on "Cognitive decline published in 1990"
Book•
01 Jan 1990
TL;DR: Lower Organisms: Identification of Longevity, Neurobiological Correlates of Age-Related Cognitive Decline: Animal Models, and Mechanisms Controlling in Vitro Cellular Senescene.
Abstract: Lower Organisms: Identification of Longevity. Assurance Genes in Yeast. Molecular Genetic Approaches to Identifying Gerontogenes in Caenorhabditis Elegans. Genetic Approaches to Life Prolongation in Drosophila Melonogaster. Mutants Affecting Senescence Processes in Plants. Changes in Gene Expression with Aging. Molecular and Cellular Biology: Mechanisms Controlling in Vitro Cellular Senescene. Mechanisms of Altered Gene Expression with Aging. Protein Modifications. Genomic and Mitochondrial DNA Alterations and Aging. Neurobiology: Neurobiological Correlates of Age-Related Cognitive Decline: Animal Models. Neuropyschological Assessment of Age-Related Cognitive Decline in Humans. Neuroendocrine Changes in Aging. Nerve Growth Factors, Neural Plasticity, And Aging. Human Biology: Aging Renal Function and Regulation of the Volume and Composition of the Extra Cellular Fluid. Depression in Old Age. Menopause and Its Consequences. Skeletal Integrity and Osteoporosis in Old Age. Overarching Areas: Excercisephysiology and Aging. Nutrition and Aging. Epidemiology of Aging.
1,269 citations
TL;DR: It is suggested that a gradual cognitive decline does not occur during the early, asymptomatic stages of HIV infection.
Abstract: Cross-sectional studies have not adequately resolved the question of whether subjects infected with HIV-1 may suffer cognitive decline during the early, asymptomatic stages of the infection. We studied longitudinally 238 asymptomatic healthy HIV-1-infected homosexual/bisexual men (CDC groups 2 and 3) and 170 uninfected controls in the Multicenter AIDS Cohort Study with neuropsychological testing at semiannual intervals. A comparison of change in scores between visits 1 and 4 as well as a multivariate autoregressive analysis revealed no evidence of decline in test performance over time in the HIV-1-infected group compared with the seronegative controls. These findings suggest that a gradual cognitive decline does not occur during the early, asymptomatic stages of HIV infection.
321 citations
TL;DR: A detailed theory of perception, production and memory for language and applies it to the problem of cognitive decline in old age was shown to account for a wide range of established age differences in cognitive ability, and to suggest an alternative framework for understanding some findings which in the past have seemed contradictory.
Abstract: Summary This chapter describes a detailed theory of perception, production and memory for language and applies it to the problem of cognitive decline in old age. Altering a single parameter in the theory (rate of priming) was shown to account for a wide range of established age differences in cognitive ability, and to suggest an alternative framework for understanding some findings which in the past have seemed contradictory. Examples of these findings are effects of age on learning, rate of processing (general slowing), and the tip of the tongue (TOT) phenomenon. The theory postulates different mechanisms for retrieving existing representations in memory vs. learning new or unique representations and predicts that new learning will be especially vulnerable to aging. Specifically, the theory predicts that age differences will increase with the number of new connections required in a memory task, but will diminish if already established connections are sufficient to accomplish the task. This prediction cuts across specific paradigms and theoretical distinctions and applies to a broad range of memory phenomena. By way of illustration, we review findings from experimental studies of encoding specificity, implicit versus explicit memory, and semantic versus episodic priming, and show how the observed pattern of age differences is consistent with disruption of new, learning and preservation of memory involving existing, connections. The theory also makes some interesting and, genuinely new predictions for future research that are, spelled out here, for example, an age-linked decline in the, detection of speech errors.
235 citations
TL;DR: In this paper, three studies were conducted to investigate effects related to age and experience on measures of spatial visualization ability and found that increased age was associated with lower levels of performance on several tests of spatial visual ability.
Abstract: Three studies were conducted to investigate effects related to age and experience on measures of spatial visualization ability. All research participants were college-educated men; those in the experienced group were practicing or recently retired architects. The major results of the studies were (a) that increased age was found to be associated with lower levels of performance on several tests of spatial visualization and (b) that this was true both for unselected adults and for adults with extensive spatial visualization experience. These findings seem to suggest that age-related effects in some aspects of cognitive functioning may be independent of experiential influences. An important hypothesis concerning the effects of adult age on cognitive functioning attributes the poorer performance of older adults to their lack of recent experience with relevant cognitive abilities. Perhaps the clearest statements of this disuse perspective were by early researchers (e.g., Sorenson, 1933, 1938; Thorndike, Bregman, Tilton, & Woodyard, 1928), but some version of the disuse hypothesis is implicit in the writings of many contemporary researchers (e.g., Ratner, Schell, Crimmins, Mittelman, & Baldinelli, 1987; Willis, 1987). As an illustration of the commitment to this perspective, Kirasic and Allen (1985), in a recent review of research on age and spatial ability, stated as an assertion rather than an hypothesis, that A substantial difference. . . [exists! between elderly adults' proficiency outside the psychological laboratory and their proficiency in performing tasks bearing an apparent relationship to their lives outside that setting. . . [and that] age-related performance decrements are more likely to appear on novel tasks or those involving unfamiliar stimuli or settings than on familiar tasks or those involving well-known stimuli or settings, (p. 199) Despite considerable intuitive appeal and apparent widespread implicit acceptance, there is still very little evidence directly relevant to the disuse hypothesis of age-related cognitive decline. The studies in the current article were designed to investigate this hypothesis by examining the effects of age, experience, and the interrelations of age and experience on spatial visualization ability. Spatial visualization, as the term is used here, refers to the mental manipulation of spatial information to determine how a given spatial configuration would appear if portions of that configuration were to be rotated, folded, repositioned, or otherwise transformed. This construct has been identified in a number of factor-analytic studies (e.g., see Lohman, 1988, for a review), and has been found to have predictive validity for success in courses in geometry, drafting, and design (e.g.,
190 citations
TL;DR: Evidence from this patient, along with similar evidence from the literature reviewed, suggests that when patients present with a progressive aphasia characterized by anomia, Pick's disease should be considered as the probable diagnosis.
Abstract: Although Pick's disease is generally considered as a dementia characterized by signs of frontal lobe dysfunction, it can present with selective language defects rather than with cognitive decline. In this study, we report prospective and serial clinical, neuropsychological, and neuroradiologic observations in a 59-year-old man whose prominent disturbance was in the retrieval and learning of names denoting concrete entities and actions. Postmortem study confirmed the diagnosis of Pick's disease and revealed that neuronal loss and gliosis were most prominent in left anterior temporal cortices. The findings are in keeping with evidence that the left anterior temporal cortices and interconnected hippocampal system are critically involved in the learning and retrieval of verbal lexical items. The evidence from this patient, along with similar evidence from the literature we reviewed, suggests that when patients present with a progressive aphasia characterized by anomia, Pick's disease should be considered as the probable diagnosis.
184 citations
TL;DR: Results indicate that the rate of cognitive decline in Alzheimer's disease is quite variable, and patients with various health and behavioral problems declined at a rate between 1.4 and 5 times faster than patients without such problems.
Abstract: Alzheimer's disease is characterized by progressive cognitive decline. However, little is known about the "typical" rate of decline, the degree of individual heterogeneity evident in decline, or the types of factors that influence such decline. This study investigated these questions in a sample of 106 patients with Alzheimer's disease, assessed at 1-5 points in time, spanning up to three years. At each time point, the Mini-Mental State Exam, a measure of global cognitive function, was administered to all patients. Measures of behavioral disturbance (including the presence/absence of hallucinations, depression, incontinence, wandering, and agitation), health status (including presence/absence of neurological, cardiovascular, and other diseases), and descriptive information (such as gender, age at time of onset, and duration of deficits) were obtained at entry into the study. A two-stage random effects regression model was fit to the data and then used to assess the effect of these behavioral, health, and descriptive measures on the rate of decline. Results indicate that the rate of cognitive decline in Alzheimer's disease is quite variable. Patients with various health and behavioral problems declined at a rate between 1.4 and 5 times faster than patients without such problems. Alcohol abuse, additional neurological disease, and agitation were significantly related to rate of decline. Overall number of problems was not. The association of these problems with accelerated decline may have prognostic and treatment implications.
170 citations
TL;DR: It is proposed that an activation of residual basal forebrain cholinergic neurons can be achieved most physiologically via inhibitory modulation of afferent GABAergic transmission, which may have a therapeutic value in treating behavioral syndromes associated with cortical cholinesterase denervation.
Abstract: The hypothesis that the cognitive decline in senile dementia is related to the loss of cortical cholinergic afferent projections predicts that pharmacological manipulations of the remaining cholinergic neurons will have therapeutic effects. However, treatment with cholinesterase inhibitors or muscarinic agonists has been, for the most part, largely unproductive. These drugs seem to disrupt the normal patterning of cholinergic transmission and thus may block proper signal processing. An alternative pharmacological strategy which focuses on the amplification of presynaptic activity without disrupting the normal patterning of cholinergic transmission appears to be more promising. Such a strategy may make use of the normal GABAergic innervation of basal forebrain cholinergic neurons in general, and in particular of the inhibitory hyperinnervation of remaining cholinergic neurons which may develop under pathological conditions. Disinhibition of the GABAergic control of cholinergic activity is assumed to intensify presynaptic cortical cholinergic activity and to enhance cognitive processing. Although the extent to which compounds such as the benzodiazepine receptor antagonistβ-carboline ZK 93 426 act via the basal forebrain GABA-cholinergic link is not yet clear, the available data suggest that the beneficial behavioral effects of this compound established in animals and humans are based on indirect cholinomimetic mechanisms. It is proposed that an activation of residual basal forebrain cholinergic neurons can be achieved most physiologically via inhibitory modulation of afferent GABAergic transmission. This modulation may have a therapeutic value in treating behavioral syndromes associated with cortical cholinergic denervation.
163 citations
TL;DR: It is concluded that 12-month-old Wistar rats may serve as the animal model of choice for the study of specific age-related behavioral deficits and that the hippocampal CA3 region might play a major role in the age-dependent cognitive decline.
146 citations
TL;DR: Either there may be two forms of PD: one with depression and rapid cognitive decline and one without depression and a gradual cognitive decline; or that the mechanisms of cognitive impairment in PD and depression may interact to produce a more rapid evolution in cognitive impairment among PD patients with a previous depression.
Abstract: The presence of depression and cognitive impairments was examined in seventy patients with Parkinson's disease (PD) Forty nine patients of this original cohort were re-examined between three and four years after the first evaluation While both depressed and non-depressed patients showed a significant decline in cognitive function during the follow up period, intellectual decline was significantly more severe for the depressed group Depressed patients also showed a faster rate of progression of motor signs (mainly tremor) than the non-depressed group Patients that died during the follow up period showed significantly more cognitive impairments than patients who were alive at follow up These findings suggest that either there may be two forms of PD: one with depression and rapid cognitive decline and one without depression and a gradual cognitive decline; or that the mechanisms of cognitive impairment in PD and depression may interact to produce a more rapid evolution in cognitive impairment among PD patients with a previous depression than among patients without a previous depression
127 citations
TL;DR: These experiments examined the effects of separate and concurrent muscarinic cholinergic and beta-adrenergic blockade on inhibitory (passive) avoidance performance and spatial learning in the Morris water maze to support a role for interactions between norepinephrine and acetylcholine in the modulation of learning and memory.
112 citations
01 Nov 1990
TL;DR: In this article, the authors make three implicit assumptions about aging: Decline from asymptotic levels attained during early adulthood is assumed to occur in old age in both biological and behavioral functioning, whether at the level of observed performance or reserve capacity.
Abstract: Introduction Social scientists who are concerned with examining the hypothesis that optimization can occur with advancing age and who direct their efforts to discover the factors that allow some but not all individuals to optimize their abilities to maintain high-quality lives generally would seem to make three implicit assumptions. The first assumption has a negative flavor: Declines from asymptotic levels attained during early adulthood are assumed to occur in old age in both biological and behavioral functioning, whether at the level of observed performance or of reserve capacity. The second assumption, by contrast, is more positive: Individuals are thought to differ widely in their adaptation to experienced losses, and patterns of individual maintenance in decline may be both varied and subject to multiple influences. The third assumption concerns the model chosen for the study of aging pheonmena: Decline with age is often thought to be gradual, continuous, and irreversible in nature. Evidence with respect to these assumptions has long been examined in the area of cognitive functioning, the topic of this chapter. Whether older adults can maintain levels of adaptation that allow continuation of independent living and the expression of accomplishments in late life is necessarily contingent upon the maintenance of levels of intellectual functioning that have not fallen significantly below the normative levels expected by our society. It is quite true that many individuals throughout much of their life manage to cope at below-average levels of competence.
TL;DR: Using intermediate weighted magnetic resonance imaging (MRI) and a systematic sampling stereological method in 39 normal volunteers aged 24-79 years old, a marked age-associated decline in caudate nuclei volume is demonstrated and the validity of this stereological technique for use with MR images is confirmed.
TL;DR: The drug was equally well tolerated and equally effective in the two major dementias of old age, i.e., primary degenerative and multi-infarct.
Abstract: 1. In a multicenter, placebo-controlled, double-blind clinical study in 178 elderly patients with cognitive decline, nimodipine, a calcium antagonist was found to be a therapeutically effective agent in the treatment of old age dementias. 2. Treatment with 90 mg of nimodipine administered orally in divided doses for 12 weeks was significantly superior to an inactive placebo on all outcome measures including the Wechsler Memory Scale, the Mini Mental State Examination, the Global Deterioration Scale, the Sandoz Clinical Assessment Geriatric Scale, the Plutchik Geriatric Rating Scale, the Severity of Illness and Global Improvement Scales of Clinical Global Impression, and the Hamilton Psychiatric Rating Scale for Depression. 3. Adverse effects with nimodipine were few and mild. The drug was equally well tolerated and equally effective in the two major dementias of old age, i.e., primary degenerative and multi-infarct. The number of abnormal laboratory test readings remained essentially unchanged from pre-treatment to post-treatment.
TL;DR: In this article, the clinical and neuropathological features of two patients having corticonigral degeneration with neuronal achromasia (CND) were described, and they had cognitive decline and movement disorders.
TL;DR: The presence of extensive deep whitematter brain lesions for up to 7 years in two subjects whose cognitive, behavioral, and neurologic functioning is unimpaired suggests that deep white-matter brain lesions do not necessarily indicate a clinically significant central nervous system disease process.
Abstract: • Although deep white-matter brain lesions are seen on magnetic resonance imaging in about one third of elderly subjects, their clinical significance is not known. In 1984, we studied three retired teachers who had extensive deep white-matter brain lesions on magnetic resonance imaging, yet functioned cognitively at an above-average level. Blinded review of 1981 computed tomographic scans revealed patchy white-matter lucencies for two of the subjects. Repeated magnetic resonance imaging in 1987 showed that the deep white-matter brain lesions were at least as extensive as in the initial study. One subject had developed renal failure, while the other two continued to function at a high level with no evidence of cognitive decline or psychiatric or neurologic impairment. The presence of extensive deep whitematter brain lesions for up to 7 years in two subjects whose cognitive, behavioral, and neurologic functioning is unimpaired suggests that deep white-matter brain lesions do not necessarily indicate a clinically significant central nervous system disease process.
TL;DR: A retrospective enquiry was made concerning the mental health of the patients in the study; cognitive performance was graded on the Global Deterioration Scale (GDS 1–7).
Abstract: Brains from 70 unselected general hospital necropsy cases aged 60-95 years were surveyed histologically for changes of Alzheimer's disease using Congo Red-Gallocyanin preparations. Counts were made of neurofibrillary tangles in two areas of the neocortex, the hippocampal formation and the substantia innominata. Neurons were counted in the subiculum of the hippocampus, the substantia innominata and the locus coeruleus. In addition, a retrospective enquiry was made concerning the mental health of the patients in the study; cognitive performance was graded on the Global Deterioration Scale (GDS 1-7). Four cases (5.7%) had clinical and pathological changes amounting to early Alzheimer's disease. Tangles were very numerous in all areas and there was a 30% deficit or more of neurons in at least two of the structures counted. Although the diagnosis of Alzheimer's disease was not recorded during life, all had shown signs of early cognitive decline (GDS grades 3-6). A further six cases (8.6%) showed excessive tangle accumulation which may represent preclinical Alzheimer's disease. Tangles were present in the temporal neocortex (Brodmann area 22), whereas they were absent in the remainder of the survey. Tangle density in the hippocampal formation (greater than 50 tangles in a 10 microns section) was also above the baseline level of the majority of cases. However, neuron loss was not widespread in these cases and none had shown evidence of cognitive impairment. The findings confirm that the early stages of Alzheimer's disease commonly occur amongst general hospital necropsies. The emergence of clinical signs of dementia appears to be related to the loss of a critical volume of neurons and not to tangle accumulation alone.
TL;DR: Sexual functioning was disrupted in a majority, with 20% meeting criteria for new onset hypoactive sexual desire disorder and in spite of intensive and repeated HIV education, 60% engaged in unprotected intercourse after knowledge of seropositivity.
TL;DR: Results indicate that performance on tests intended to measure cognitive decline in the elderly does have a significant genetic component and that these estimates tend to increase after adjustment for covariates.
Abstract: • The genetic contribution to performance on scales designed to measure mild to moderate decrements in cognitive functioning in a population at risk is unknown. In the present analysis, 134 monozygotic and 133 dizygotic male twin pairs (mean age, 63 years) were given three cognitive tests: the Mini-Mental State examination, the Iowa Screening Battery for Mental Decline, and, for comparison, the Digit Symbol Substitution Test from the Wechsler Adult Intelligence Scale. The primary objective of the analysis was to test for a significant heritable component to performance on these measures. A secondary objective was to determine the extent to which shared variance with significant confounders such as education, age, and depression affects the outcome of the heritability analysis. Results indicate that performance on tests intended to measure cognitive decline in the elderly does have a significant genetic component and that these estimates tend to increase after adjustment for covariates. Heritability estimates adjusted for covariates were 30% for the Iowa Screening score, 60% for the Mini-Mental State score, and 67% for the Digit Symbol Substitution score.
TL;DR: Cognitive performance correlated positively with fast (beta) activity particularly in frontal leads, even after controlling for age, education, occupation, and medication.
Abstract: We obtained a topographic computer analysis of the electroencephalogram in 53 normal elderly subjects. Normal aging was not associated with an increase in slow (delta) activity. However, cognitive performance correlated positively with fast (beta) activity particularly in frontal leads, even after controlling for age, education, occupation, and medication. Five subjects who showed early signs of cognitive decline, had all a marked reduction in beta activity suggesting that this may be an early indication of intellectual loss.
TL;DR: The possibility of administering only a part of the National Adult Reading Test-NART, a regression equation has been developed to predict performance on the second half of the test, and results were highly significantly correlated with the actual NART score for all groups.
Abstract: Estimation of premorbid IQ is useful for estimating true cognitive decline in dementia. The National Adult Reading Test-NART (Nelson, 1982)-has been shown to estimate premorbid IQ in hospital patients. NART is potentially of use in epidemiological studies. However, asking community elderly people to read a list of irregular and difficult words can cause distress. This paper explores the possibility of administering only a part of the NART. On the basis of scores on the first half of the test from an elderly rural community sample (N = 316), a regression equation has been developed to predict performance on the second half of the test. It was built using the scores of half the population free from clinical diagnoses and tested on the other half. It was also applied to a demented group and a depressed group from the same population. Total NART scores predicted in this way were highly significantly correlated with the actual NART score for all groups. Recommendations about the use of this shortened test are made.
TL;DR: A neuropsychological test battery for screening, staging and monitoring cognitive impairment in AD patients and for delineating their pattern of cognitive decline proved capable of accurately screening early demented from non-demented elderly subjects and of staging mild, moderate, severe and very severe mental impairment.
TL;DR: The findings support previous reports that language impairment may be central to the dementia of AD, and that confrontation naming is particularly sensitive to decline in this illness.
Abstract: Progressive cognitive impairment is a defining feature of the dementia of Alzheimer's disease (AD), yet disagreement exists over which abilities decline most precipitously and which cognitive tests are more sensitive. In this study, 51 AD patients in the early to middle stages of illness and 22 age-matched normal controls were administered a battery of neuropsychological tests at 6-month intervals over a 2-year period. While the performance of the normal controls remained stable over the 2 years, the AD patients displayed progressive decline on all tests. The greatest declines occurred on tests requiring lexical/semantic processing (Boston Naming Test) and comprehension of syntactic relationships (Token Test). Performance on visuospatial tests (Wechsler Adult Intelligence Scale-Revised Block Design, Benton Visual Retention Test, Spatial Delayed Recognition Span Test) declined less rapidly. The findings support previous reports that language impairment may be central to the dementia of AD, and that confrontation naming is particularly sensitive to decline in this illness.
TL;DR: Reinstitution of higher oral doses of corticosteroids successfully prevented further cognitive losses and permitted gradual but incomplete improvement of cognitive function in 1 patient, and the 3rd patient appeared clinically to be globally, severely demented.
Abstract: Dementia occurs infrequently in patients with giant cell (temporal) arteritis (GCA). Three elderly women with biopsy-proven GCA showed abrupt cognitive decline during periods of clinically active GCA, 1 to 6 months after diagnostic temporal artery biopsy, during periods of corticosteroid taper. One patient had additional clinical signs of cerebral infarction and other ischemic phenomena. Reinstitution of higher oral doses of corticosteroids successfully prevented further cognitive losses and permitted gradual but incomplete improvement of cognitive function in 1 patient. Neuropsychologic data from 2 patients 7 to 10 months after temporal artery biopsy suggested multifocal cognitive impairment, and the 3rd patient appeared clinically to be globally, severely demented. Neuroimaging studies revealed multiple areas of infarction, predominantly in the posterior circulation territory. One patient had bilateral vertebral artery occlusions (digital subtraction angiography) and bilaterally reduced carotid system perfusion pressures (oculoplethysmography). There were no associated cardiovascular risk factors or family history of dementia in these patients.
TL;DR: NART was found to be strongly related to current level of cognitive function as measured by the Mini Mental State Examination and CAMCOG-the neuropsychological battery of the Cambridge Examination for Mental Disorders in the Elderly.
Abstract: The National Adult Reading Test (NART) has become widely used by psychologists in clinical practice as part of the assessment of cognitive decline in organic mental disorders. Some normative data have been presented on community samples from a wide range of ages, but little is known of the instrument's performance in true community samples of the elderly. This study presents data on NART from an epidemiological study of dementia and cognitive impairment in elderly women. The contribution of educational level and social class to performance on the scale was examined. NART was found to be strongly related to current level of cognitive function as measured by the Mini Mental State Examination and CAMCOG - the neuropsychological battery of the Cambridge Examination for Mental Disorders in the Elderly. For most subjects in the community the NART was found acceptable as a measure of premorbid intelligence.
TL;DR: Current evidence particularly suggests that subcortical atrophy may be an important factor in the genesis of affective disorder in old age, and the use of brain imaging techniques may have particular bearing upon identification of etiology of Affective disorder, prediction of treatment response, or risk of relapse.
Abstract: Within the past two decades brain imaging techniques have given the clinician access to new anatomical and functional findings for dealing with affective disorder in the older age group. Despite the proliferation of such technology, the significance of findings on computerized axial tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) remains unclear in this patient group. The literature covering old age depression and imaging techniques is reviewed, and problems related to methodology, sample selection, and implications for the direction of future research are discussed. Current evidence particularly suggests that subcortical atrophy may be an important factor in the genesis of affective disorder in old age. The question of cognitive decline in the setting of affective disorder is examined. The use of brain imaging techniques may have particular bearing upon identification of etiology of affective disorder, prediction of treatment response, or risk of relapse.
TL;DR: Ulastructural examination of skin biopsy in 5 patients with Niemann-Pick disease, type C demonstrated lysosomes containing loosely arrayed dark lamellated structures within a clear matrix, demonstrating the usefulness of this simple and readily available morphologic test for the diagnosis of NiemANN- pick disease,type C.
TL;DR: Performances in memory and learning tasks were normal, as compared with those of a control group (24 healthy volunteers), and Auditory word learning was particularly vulnerable; however, acquisition rate was not significantly different between MS patients and controls.
01 Jan 1990
TL;DR: An abnormally long or absent P300 correlated with deficits on select cognitive tasks: those involving memory, visual perception, and abstract reasoning, and the interactions between anatomical and neurochemical abnormalities in PD are discussed in light of the pattern of deficits seen.
Abstract: An abnormally prolonged latency of the P 300 event-related potential has been reported in several types of dementing illnesses, including Parkinson's disease (PD). While some PD patients have dementia, a significant number of PD patients have less severe cognitive impairments. We examined the relationship between the auditory P 300 and a neuropsychological battery of 11 tasks in 43 PD patients. The quantitative relationship between the individual neuropsychological measures and the P 300 was examined using partial correlation and analysis of covariance techniques which controlled for age, education, and illness duration. The strongest correlations were between P 300 and both short-term memory and visual perception. Global cognitive deficits do not appear to relate to the abnormal P 300 responses in PD: instead, specific aspects of cognitive decline accounted for the electrophysiological abnormalities. An abnormally long or absent P 300 correlated with deficits on select cognitive tasks: those involving memory, visual perception, and abstract reasoning. The interactions between anatomical and neurochemical abnormalities in PD are discussed in light of the pattern of deficits seen in this study.
TL;DR: Results show that moclobemide may improve cognition in conditions associated with cholinergic deficit, and may therefore be especially indicated in the treatment of cognitive decline occurring with normal aging, depression in elderly people and Alzheimer's disease.
Abstract: After a baseline performance assessment, 28 healthy male volunteers received subcutaneous injections of scopolamine hydrobromide to induce deficits in memory, attention and cognitive processes Subsequent performance testing established the decrements caused by the scopolamine, and then each subject was given one of 3 investigational drugs including moclobemide, or placebo, according to a latin-square design Parallel versions of the test procedures were used to assess drug effects on the scopolamine-induced cognitive deficits Whereas marked and statistically significant impairment was identified 60 min after scopolamine injection, the global analysis revealed statistically significant superiority of moclobemide over placebo at 120 min in relieving the scopolamine-induced decrement in performance These results show that moclobemide may improve cognition in conditions associated with cholinergic deficit It may therefore be especially indicated in the treatment of cognitive decline occurring with normal aging, depression in elderly people and Alzheimer's disease
TL;DR: The author describes the size of the problem, the diagnostic criteria of dementia as well as the differential diagnosis, and the validity study of Hasegawa's dementia scale which is widely used as the screening instrument of the demented aged in Japan.
Abstract: The dementing disorder constitute the largest single problem because of the state of extreme helplessness that characterizes its advanced stages. The clinical psychiatry have to face with this disabling disease, for which the adequate treatment or strategies have not been established. Firstly the author describes the size of the problem by introducing our recent epidemiological study on age-related dementia in Kanagawa Prefecture. The result of the study revealed that the prevalence of dementia was 4.8% and it increased with age. The other recent epidemiological study also showed similar findings. One of the common findings in these studies was that the prevalence of senile dementia was much lower than that of vascular dementia and apparently indicated the reverse tendency reported in the traditional studies in Europe and USA. Secondly the author discusses the diagnostic criteria of dementia as well as the differential diagnosis. Thirdly he describes the validity study of Hasegawa's dementia scale which is widely used as the screening instrument of the demented aged in Japan. The author also describes the Hasegawa's scale was applicable for research tool for the measurement of cognitive decline of the very old aged by introducing the centenarian study. Lastly the author states the issues of family care status of the demented elderly and emphasized the importance of caring the care-givers in the family.