| 1. |
- Minthon, Lennart, et al.
(författare)
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Tacrine treatment modifies cerebrospinal fluid neuropeptide levels in Alzheimer's disease
- 1994
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Ingår i: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 5:6, s. 295-301
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Tidskriftsartikel (refereegranskat)abstract
- Biochemical and histochemical studies have demonstrated a widespread deficit in the activity of acetylcholinesterase (AChE) in the brains of patients with Alzheimer's disease (DAT). Multiple disturbances in several transmitter systems have been found. The most consistent neurochemical changes in DAT are reductions in the cholinergic system. The major pharmacological approach today in DAT is based on the cholinergic theory assuming that acetylcholine has a major cortical impact on cognitive processes. Tetrahydroaminoacridine (THA, tacrine) is a centrally active reversible acetylcholinesterase inhibitor. A large number of trials have been performed in patients with DAT. This article was to evaluate whether THA treatment induced neuropeptide alteration in DAT before and after 1 year on oral THA treatment.
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| 2. |
- Elfgren, C., et al.
(författare)
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Neuropsychological tests as discriminators between dementia of Alzheimer type and frontotemporal dementia
- 1994
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 9:8, s. 635-642
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine whether cognitive test performance alone could distinguish patients with dementia of Alzheimer type (DAT) from those with frontotemporal dementia (FTD). Scores from three neuropsychological tests were used as discriminating variables in 28 cases with postmortem verified diagnoses. The selected tests measured verbal ability, visuospatial ability and verbal memory. Eighty-nine per cent of the sample was correctly classified by discriminant analysis. Evaluating the ability of the obtained discriminant function to differentiate between groups of DAT and FTD in a new, clinically diagnosed sample of 38 cases yielded an overall success rate of 84%. The results suggest that cognitive tests may be helpful for differential diagnosis in the context of a neuropsychiatric examination.
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| 3. |
- Elmstahl, S., et al.
(författare)
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Quantitative EEG in elderly patients with Alzheimer's disease and healthy controls
- 1994
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Ingår i: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 5:2, s. 119-124
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Tidskriftsartikel (refereegranskat)abstract
- Multichannel (19) EEG were analyzed in 23 female patients with rather advanced late-onset Alzheimer's disease (AD) and compared with 56 age- and sex-matched healthy control subjects. The quantified EEG was correlated with psychometric and clinical variables. The control subjects showed increasing theta activity with age but the EEG changes did not correlate significantly with psychometric features. The AD patients showed highly significant increases in delta and theta activity and decreases in beta activity compared with controls. The EEG changes were most marked over posterior regions of the brain. The individual EEG variables showed a high degree of intercorrelation and an almost complete discrimination between patients and controls was accomplished by taking only the posterior delta activity into account. In a subgroup of 10 patients, in which a Mini Mental test score could be obtained, the score correlated with the relative theta power.
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| 4. |
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| 5. |
- Sällström, Christina, 1950-
(författare)
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Spouses' experiences of living with a partner with Alzheimer's disease
- 1994
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the study was to gain some understanding of the lived experience of the care-giving spouses regarding their experiences of the manifestations of the disease, perception of their own health, the possibility of influencing the interpretation of the past, the present and future, outlook on life, surrounding contacts and intimate relationships with their sick partners. The spouses (n=13) of Alzheimer victims were followed with the help of personal interviews, diaries and telephone interviews during a two-years period. The texts was analysed according to a phenomenological-hermeneutic method. The main findings in the study showed that the spouses own health remained quite stable over time. Their perception of the development of their own health seemed to be influenced by how they saw their power to influence their situation, which seemed to be determined by how they interpreted the cause of their health problems.The social network was another important factor for understanding the spouses' experiences. The findings imply that spouses' images of themselves in relation to others were important for their perception of the overall social network. The spouses mostly regarded their relationships positively and their social networks were described as quite stable over time. The spouse's marital relationships, in most cases, seemed to undergo changes with the progress of the disease. Some spouses could maintain feelings of love but mostly the relationships were transformed into ones of tenderness, pity and estrangement. The spouses' valuation of their demented partner was mostly in the form of one of two divergent perspectives. On the one hand, spouses who seemed to perceive their partner as a person separate from the disease, could function as complementary ego aids. On the other hand some spouses were unable to make a distinction between the spouse as a person and the disease.The spouses' experiences regarding their previous relationship with parents, value system, philosophy of life, competence and autonomy seemed to be critical in their experiences of their caring situation. It appears that there is a sub-group of vulnerable carers, as suggested by the concurrence of psychological, physical, and social morbidity, along with deterioration in their marital relationship.The findings are discussed in relation to searching for meaning, the importance of significant others, perceiving and valuing the other, and caring relationships within a life-span perspective.
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| 6. |
- Elmståhl, Sölve, et al.
(författare)
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A study of regional cerebral blood flow using 99mTc-HMPAO-SPECT in elderly women with senile dementia of alzheimer’s type
- 1994
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 5:6, s. 302-309
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Tidskriftsartikel (refereegranskat)abstract
- Thirteen women with senile dementia of Alzheimer’s type (SDAT) according to NINCDS-ADRDA and 21 age-matched control women, aged 75-96 years, were investigated with clinical examination, dementia rating scales and single photon emission computed tomography (SPECT) using99mTc-hexamethylpropyleneamine oxime (HM-PAO) as a tracer of regional cortical blood flow. The aim was to study whether typical SPECT findings of SDAT were seen also in the very old having the disease for a longer period. Neuropsychological assessment with vocabulary and spatial tests was performed in the control women, and the results were divided in three subgroups, normal, borderline and abnormal. Regional perfusion values, expressed as a ratio between cortical and cerebellar HM-PAO uptake, were lower in frontal, temporoparietal and occipital cortices in SDAT patients than in controls. The SDAT patients had the lowest uptake in the posterior temporoparietal region (0.67 ± 0.06) and the corresponding value in the controls (0.79 ± 0.05) differed significantly, p < 0.0001. The interhemispheric ratio between right and left posterior temporoparietal regions was 0.99 ± 0.05. Nine of the control women (43%) had pathological SPECT with hemispheric asymmetries in 6 cases and bilateral temporooccipital reductions in 3 women. The neuropsychological assessment matched the findings in 7 of these women. One of the control women was judged as pathological and 10 women as borderline according to the spatial and vocabulary tests. Four of the 10 women with borderline results had normal SPECT. The sensitivity of the assessment to detect abnormalities compared to SPECT was 78% if borderline and abnormal results were expressed as true-positive cases. The specificity was 67%. The results showed a high degree of pathological findings according to SPECT and neuropsychological assessment in otherwise healthy elderly women.
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| 7. |
- Styrborn, Karin, et al.
(författare)
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Outcomes of geriatric discharge planning. A quality assurance study from a geriatric rehabilitation ward
- 1994
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Ingår i: Scandinavian Journal of Rehabilitation Medicine. - Oslo, Norway : Scandinavian University Press. - 0036-5505 .- 1940-2228. ; 26:3, s. 167-176
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Tidskriftsartikel (refereegranskat)abstract
- The outcome of a discharge planning procedure at a geriatric rehabilitation ward was studied with an interdisciplinary and multidimensional approach, where medical, nursing, functional and psychosocial factors were included. The patient's own expectations and attitude to functional performance and outcome were explored in an interview at the day of discharge and one month later in a follow-up telephone interview. Data were also collected from registers and medical and professional records. All the 36 patients discharged to their own homes, mostly after home assessment, or to old people's homes were followed up. The median rehabilitation stay was 30 days. Their medical status was stable over time and nursing interventions remained frequent. The functional level was unchanged for 18, and further enhanced for 10 patients. Most patients felt secure at home and received the home help they anticipated. Worries were expressed by one-third on realistic grounds, mainly medical or ideas on the accommodation. Some interventions were required and carried out by the team. Home living was as expected or better for two-thirds of the patients. The timing and the patient's situation at discharge seemed to have been well assessed, with an overall positive outcome after a month at home. Further development of practical multidimensional evaluations adapted to elderly patients is necessary in a quality assurance perspective.
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