Journal of the American Geriatrics Society
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Although some researchers have suggested that the dexamethasone suppression test (DST) may be useful in differentiating between major depression and dementia in the elderly, recent reports of abnormal DST results in nondepressed, demented elderly have questioned the validity of the test in this population. This study compared the frequency of abnormal DST results in three groups of elderly inpatients: depressed/not demented; demented/not depressed; and depressed and demented. ⋯ In this sample, the DST was more likely to identify dementia than depression. Until further investigations clarify the parameters of DST use in the elderly, the diagnosis of depression and dementia should continue to be determined by sensitive interpretation of clinical findings, history, and other diagnostic tests.
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Patients with temporal arteritis may be misdiagnosed because the headache does not affect the temples. The records of 24 patients with biopsy proven temporal arteritis were reviewed to determine the site and other qualities of headache. Past reports of the sites of headache in this disease were also reviewed. ⋯ Two patients had generalized headaches. The headache did not involve the temple in seven patients and two patients did not experience headaches. Temporal arteritis should be considered in every elderly individual who begins to complain of headache, no matter what the site, quality, severity, or time pattern.