Articles: dementia.
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The metabolism of (U--14C) glucose and its incorporation into acetylcholine were determined in vitro in fresh cortical biopsy samples from patients with Alzheimer's disease and controls. Synthesis of 14C acetylcholine was significantly reduced (60% and 67% reduction under stimulated and resting conditions, respectively) without significant changes in the overall metabolism of glucose (as measured by 14CO2 production). ⋯ The changes in cholinergic markers reflected the severity of psychological defects. Acetylcholine synthesis was not reduced in biopsy samples from patients suffering from presenile dementia with no histological evidence of Alzheimer's disease.
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Most of the elderly with psychiatric disorders are unknown to mental health facilities and untreated by psychiatrists. Many of this population may be under the care of family physicians. ⋯ Physicians' attitude and training create the possibility that treatable illnesses are misdiagnosed as irreversible dementia. A more optimistic approach to the treatment and prognosis of mental disorders in the aged is warranted.