A Burns

..The aim of this trial is to establish the most effective drug option for people with AD who are progressing from moderate to severe dementia despite treatment with donepezil...

..The study aims to quantify the population impact of prescribing cholinesterase inhibitors to slow the cognitive decline in Alzheimer's disease (AD), and to compare with the benefit of treating hypertension to prevent the onset of AD...

..This may be important in the earlier stages of Alzheimer's disease, where insight is often preserved...

..Defining treatment success in progressive diseases, such as Alzheimer's disease (AD), can be challenging...

..The efficacy of galantamine has been shown in patients with mild, moderate, and advanced moderate Alzheimer's disease (AD). Here we report its efficacy in patients with severe AD...

..Alternatives to drug treatment for agitation should be sought. The study aimed to assess the effects of bright light therapy on agitation and sleep in people with dementia...

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..To evaluate the effect of a psychiatric intervention in treating depression (treatment study) and the effect of a psychological treatment in preventing depression (prevention study) after hip fracture in older people...

..Patients, their carers, and clinicians deserve to be optimistic in a field which often attracts therapeutic nihilism...

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..The results underscore the need for formal cognitive assessment and the requirements for training in the administration of cognitive tests...

..There has been little direct comparison of cultural differences between countries and the effect any differences may exert on the outcome of caregiver interventions...

..To compare nurse initial diagnoses following domiciliary visits with subsequent formal multidisciplinary formulation based upon the full possession of investigations, neuropsychological tests and brain imaging...

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..Facilitating activities that are enjoyed by both patients with dementia and spouses may be an alternative intervention strategy to reduce carer burden...

..Asymptomatic spontaneous cerebral emboli (SCE) are common in dementia and are associated with cognitive decline in dementia. The significance of their presence in older people is unknown...

..There are shortcomings in the standard of both hospital and community care, and the cost implications of providing adequate services are high...

..In addition, there is a significant negative correlation between SCE and DWMH in VaD, which supports the hypothesis that VaD may be the result of ischaemic injury, predominantly reflecting embolic aetiology...

..To assess perceived need and adequacy of service provision by old age psychiatrists (OAPs) to older people living in care homes in the UK...

..We reviewed the potential role of paradoxical embolization in AD...

..We conclude that the UK version of D-QOL is a reliable and valid measure of quality of life in UK population with mild to moderate dementia...

..Health of the Nation Outcome Scales (HoNOS) have been developed to measure of outcomes in people with mental health problems...

..To examine whether asymptomatic spontaneous cerebral emboli (SCE) predicts subsequent depression in older people...

..CONCLUSION: Depressive symptoms occur in AD when co-existing depression is ruled out. Their recognition has implications for the diagnosis of major depression in these patients...

..83, sensitivity=0.78, specificity=0.78). CONCLUSIONS: A GANN is able to discriminate a clinically distinct group of features among dementia patients who express the epsilon4 allele...

..CONCLUSIONS: The results suggest that right hemisphere impairment underlies the specific profile of cognitive impairment in elderly patients with schizophrenia...

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..The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia...

..Mental illness and cognitive impairment are risk factors for poor dental health...

..This study examines the value of such collaboration in the assessment of older people at risk of entering care homes...

..The aim of this study was to examine knowledge of dementia in South Asian older people, as compared with Caucasian older people...

..80 to 3.07) and 1.67 (0.81 to 3.41). CONCLUSION: Spontaneous cerebral emboli were significantly associated with both Alzheimer's disease and vascular dementia. They may represent a potentially preventable or treatable cause of dementia...

..In England, the National Service Framework for Older People (NSFOP) sought to address these inconsistencies and improve care. This study describes the situation three years after its publication...

..To examine the association between the angiotensin-converting enzyme (ACE) deletion/insertion (D/I) polymorphism and white matter hyperintensities (WMHs) in patients with dementia...

..This study tested the hypothesis that dilation of Virchow-Robin spaces seen on Magnetic Resonance Imaging (MRI) is associated with treatment resistance in elderly depressed individuals...

..The implementation of the original NICE (2001) guidance that made these drugs available in the UK was not examined in this review process, and was the objective of this study...

..To investigate psychiatric morbidity, cognitive impairment, dependency, and survival in residents newly admitted to care homes...

..There are a number of newer drug therapies in various stages of pharmacological development, but donepezil should continue to play a major role in the treatment of Alzheimer's disease for the next few years...

..SCE may represent a potentially treatable target to slow and possibly prevent dementia, both AD and VaD...

..The implications of these findings and the challenges inherent in providing integrated care for this client group are discussed...

..Knowledge of suicide in people with dementia is limited to small case series...

..This paper presents the results of a trans-cultural study looking at the possible differences in the symptomatology of Alzheimer's disease (AD) in people from Manchester, UK and Rawalpindi, Pakistan...

..Spontaneous cerebral emboli (SCE) are frequent in Alzheimer's disease (AD) and vascular dementia (VaD). We investigated the effect of SCE on the rates of cognitive and functional decline in AD and VaD...

..Late-onset depression (LOD) has a poor prognosis which may be worsened by the presence of cerebrovascular disease. Few studies have explored prospectively the influence of vascular risk factors on longer term prognosis...

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..However, this retrospective analysis suggests that rivastigmine 6-12 mg/day may benefit subjects with more severe disease, as well as subjects with mild to moderate impairment...

..44, was highest in the 60-69 years age class, progressively decreasing either side of this age group. APOE epsilon4 allele therefore has its maximum impact between onset ages of between 60 and 70 years...

..In this review, the evidence and appropriateness of both types of intervention for behavioral and psychiatric symptoms in Alzheimer's disease are discussed...

..This article describes practical issues faced when implementing light therapy in a nursing home setting, and attempts to address existing perceptions about its effectiveness...

..There is a vast array of scales available to assess all aspects of mental and physical health in older people which may be of relevance to the work of old age psychiatrists...

..These results provide key material for shaping the provision of psychiatric services for older people..

..To assess whether a selective serotonin reuptake inhibitor is effective in the treatment of stroke-associated lability of mood...

..to ascertain the value of employing a specialist clinician's contribution to the assessment of older people prior to care home entry...

..Ample evidence suggests that biological substrates underlie many psychotic symptoms. More research will identify causal links between brain changes, symptom appearance, and the effects of psychosocial factors in their genesis...

..The design of the trials in vascular dementia needs to account for these features. The specific area of BPSD in vascular dementia, their assessment, and relationship to the design of trials are considered in this article...

..The study concludes that clinicians generally consider these treatments to be beneficial, and that the provision of support to caregivers seems to further enhance the perceived benefits...

..Further double blind prospective studies are needed to understand natural progression of personality changes in AD and to validate the findings of this study...

..This suggests that microvascular abnormality is the dominant pathogenetic factor in LA even in the presence of severe stenotic/occlusive large vessel disease...

..Recognition and treatment of the underlying dental infection is required to allow the resolution of the associated skin lesion. Two illustrative cases are presented...

..Depression is the commonest mental health problem in elderly people and continues to be underdiagnosed and undertreated...

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..Social and health services are jointly administered and this arrangement should, in theory, promote collaborative working and interdisciplinary arrangements...

..All eight families with the +16 mutation seem to be part of a common extended pedigree, possibly originating from a founder member residing within the North Wales region of Great Britain...

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..Overinvolved carers made attributions of the patient's behavior to causes external to the patient and internal to themselves. Cortisol levels were associated with self-reports of strain and distress...

..1%; donepezil 10 mg/d, 21.8%; P=0.005 versus placebo). CONCLUSIONS: These data demonstrate that donepezil is an effective and well-tolerated treatment for VaD and show it may have an important place in the management of this condition...

..Clinical trials in vascular cognitive impairment are in their infancy but support the value of therapeutic interventions for symptomatic treatment...

..To increase awareness of psychological factors in recovery from hip fracture and to describe strategies that can be used to help patients in the process of recovery...

..The aim of the study was to investigate whether possession of the epsilon4 allelic form of the apolipoprotein E (APOE) gene increases the risk of developing vascular dementia (VaD)...

..CONCLUSION: Fear of falling and cognitive functioning may be more important than pain and depression to predict functional recovery after hip fracture surgery. Rehabilitation strategies should take this into account...

..To assess the effect of rivastigmine in patients with mild cognitive impairment (MCI) on the time to clinical diagnosis of Alzheimer's disease (AD) and the rate of cognitive decline...

..An individually tailored approach taking all these aspects into account is warranted as it may offer more, and better, pharmacological and non-pharmacological treatment opportunities...

..The incidence of new-onset depressive symptoms in patients initially not depressed after hip fracture surgery and their relationship with functional recovery is unknown...

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..Culture-sensitive strategies to promote public knowledge and destigmatize dementia are essential. Policy makers and authorities should be made aware of the benefits of early access to diagnosis and treatment...

..Organic factors are thought to be important in late-life depressive disorder but there have been few studies specifically of neurological signs...

..Depression is the most common mental health disorder in people aged over 65 years. Late-life depression is associated with chronic illness and disability...

..audiological function is impaired in people with dementia and poor hearing is known to exaggerate the effects of cognitive deficits...

..The consensus statement aims to stimulate ethically acceptable research in the field of dementia and the protection of vulnerable elderly patients with dementia from application of inadequate research methods or designs...