Lancet
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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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In a retrospective study of necropsies done in a general hospital over five years (1971-75), fatal strokes in elderly patients often appeared to be due to acute hypotension caused by such extracranial events as heart-failure, occult haemorrhage, or multiple pulmonary emboli. In patients over the age of 60, 47 out of 120 strokes were interpreted as being caused in this way; in patients aged 70 or more, 35 out of 72. The findings suggest that more active investigation and treatment of such extracranial disease might improve the prognosis of the elderly patient with stroke.