Articles: dementia.
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Mental status testing is an essential element of evaluating elderly patients. A structured examination often helps identify the etiology of symptoms that are responsible for changes in patient behavior, that lead to family stress, but that are otherwise not indicative of cognitive dysfunction. ⋯ This article examines the steps in mental status assessment and the commonly used assessment instruments. The experience of a family medicine ambulatory multidisciplinary evaluation service in mental status testing is discussed.
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Empirical observations suggest a preponderance of cases of sporadic Alzheimer's disease among whites relative to blacks. If true, this might indicate a genetic basis for non-familial Alzheimer's disease. Among 6,000 consecutive autopsies performed at The Johns Hopkins Hospital, 242 adults with dementia were identified. ⋯ Among the remaining 144 cases, the proportions of whites and blacks were similar, yet the frequency of Alzheimer's disease was 2.6 times higher among whites (P = 0.001), dementia due to Parkinson's disease was more frequent among whites (P = 0.05), and the frequencies of multi-infarct dementia and dementia due to chronic ethanol abuse were higher among blacks (P = 0.004 and P = 0.007, respectively). Moreover, in brains from neurologically intact controls, incidental histologic lesions of Alzheimer's disease were observed more frequently in whites than blacks (P = 0.01). These findings provide a strong argument in favor of genetic transmission of sporadic Alzheimer's disease.
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This article reports the development of a small pilot program and briefly describes its activities. The growing number of dementia patients in American communities indicates a need to extend hospice services to these patients and their families. ⋯ The Alzheimer's Family Care Hospice has provided services to eight terminally ill dementia patients and their families in a pilot project sponsored jointly by the Rush Alzheimer's Disease Center and the Chicago Area Chapter of the Alzheimer's Association. Another six patients did not meet admission criteria.