The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
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Am J Geriatr Psychiatry · Jan 1998
Delusions and hallucinations in an adult day care population. A longitudinal study.
The frequency of the manifestation of delusions and hallucinations (d/h) among participants of adult day care centers was examined, as was the relationship of d/h to demographic and medical variables, agitation, depressed affect, and dementia. Changes in d/h were also assessed over a 1-year period, and those changes were compared with changes in agitation, depressed affect, and dementia. ⋯ Dementia was also related to d/h, although a substantial percentage of individuals who were not diagnosed with dementia also experienced some type of d/h. Finally, delusions were more prevalent and generally tended to relate more strongly to agitation, depressed affect, and dementia than did hallucinations.
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Am J Geriatr Psychiatry · Jan 1998
Measuring delirium severity in older general hospital inpatients without dementia. The Delirium Severity Scale.
The authors evaluated the validity, reliability, and sensitivity to change of the Delirium Severity Scale (DSS), a 10-minute assessment consisting of Forward Digit Span and Similarities. Twenty-two older inpatients with delirium but not dementia and 15 control patients were administered the DSS during hospitalization. ⋯ The DSS showed significant improvement over time (P < 0.001) and significant correlation with improvement in expert ratings (P = 0.026). The DSS shows promise as a valid and reliable measure sensitive to changing symptom severity.
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Am J Geriatr Psychiatry · Jan 1998
Incidence of asystole in electroconvulsive therapy in elderly patients.
The authors prospectively investigated the incidence of asystole (absence of heartbeat for 5 seconds) in elderly patients receiving electroconvulsive therapy (ECT) at a university-based geriatric psychiatry unit. In all, 65.8% of patients experienced asystole at some time during their course of ECT. Those who experienced asystole were significantly younger (average age, 72.2) than those without asystole (average age, 77.0; P = 0.026) and were also less likely to have cardiac rhythm disturbances on electrocardiogram (P = 0.024). ⋯ Asystole is a common side effect of ECT in elderly patients. It was not associated with any untoward outcome. The fact that "old-old" patients and those with cardiac disease are less likely to experience asystole than younger, healthier patients is reassuring to practitioners of ECT.
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Am J Geriatr Psychiatry · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of trazodone and haloperidol for treatment of agitation in patients with dementia.
The authors compared the efficacy and side effects of trazodone and haloperidol for treating agitated behaviors associated with dementia. Twenty-eight elderly patients with dementia and agitated behaviors were randomly assigned to double-blind treatment with either trazodone (50-250 mg/day) or haloperidol (1-5 mg/day) for 9 weeks. ⋯ Improvement in individual areas suggested that repetitive, verbally aggressive, and oppositional behaviors responded preferentially to trazodone, whereas symptoms of excessive motor activity and unwarranted accusations responded preferentially to haloperidol. These results indicate that moderate doses of trazodone and haloperidol are equally effective for treatment of overall agitated behaviors in patients with dementia, but specific symptoms may respond preferentially to a particular agent.
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Am J Geriatr Psychiatry · Jan 1997
An open pilot study of citalopram for behavioral disturbances of dementia. Plasma levels and real-time observations.
Citalopram, in European studies, has shown some early promise for treatment of poststroke depression and behavioral complications of dementia. An open pilot study of citalopram was conducted in 16 patients with dementia and behavioral disturbances. ⋯ The mean citalopram plasma level-to-dose ratio was found to be twice that previously reported in younger patients. These pilot findings should encourage future placebo concentration-controlled trials.