Articles: dementia.
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Comparative Study
Medial temporal atrophy as a magnetic resonance imaging marker for Alzheimer's disease.
Medial temporal lobe atrophy (MTLA) on brain magnetic resonance imaging (MRI) may help differentiate Alzheimer's disease (AD) from multiinfarct dementia (MID) and other dementias. MTLA was seen in 6 of 11 patients with clinically diagnosed AD, 16 of 20 with mixed dementia (with both AD and MID), 1 of 5 with psychiatric disease, and in none of 32 with MID or 8 with other dementias (p less than 0.0001). Increased patchy periventricular signal, or "unidentified bright objects" were seen in 2 of 11 patients with AD, 10 of 20 patients with AD and MID, and 26 of 32 patients with MID. A larger series with autopsy correlation may verify that MTLA is a reasonably specific marker for AD, and unidentified bright objects are a sensitive, but not specific, marker for vascular dementias.
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In this second segment of a panel discussion on aging and mental health, panelists focus on the primary care evaluation and management of the patient with dementia, including differential diagnosis of depression. Other topics of discussion include the roles of psychiatric referral and psychotherapy in patient management, suicide prevention, and alcoholism in elderly patients.
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Gen Hosp Psychiatry · Mar 1992
Clock drawing in the screening assessment of cognitive impairment in an ambulatory care setting: a preliminary report.
In an exploratory study to assess the utility of clock drawing as a screening test for cognitive impairment in medical/surgical outpatients, clock drawing and the 6-item Orientation-Memory-Concentration Test (OMCT) were administered to over 400 randomly selected ambulatory patients over the age of 55 in a busy inner-city hospital. The clock drawing test was completed by 431 patients, and 471 completed the OMCT. Clock drawing errors suggestive of moderate-to-severe cognitive impairment were found in 42.7% of patients; OMCT errors suggestive of moderate-to-severe cognitive impairment were found in 35.4% of the population tested. The clock drawing test might represent a quick-screen for cognitive impairment in an older general medical/surgical outpatient population, and might help identify patients not otherwise recognized as potentially unable to fully understand treatment recommendations.
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We determined the prevalence of dementia and probable senile dementia of the Alzheimer type (SDAT) for biennial Exam 17 of the Framingham cohort (1982/1983). The prevalence of dementia was 30.5/1,000 for men and 48.2/1,000 for women and increased with advancing age. ⋯ Prevalence of dementia and probable SDAT were greater for women than men. The female:male ratio of prevalence for cohort members 75 years of age and older was 1.8 for all cases of dementia and 2.8 for cases of probable SDAT.