Zeitschrift für Gerontologie
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A semi-structured interview was administered to the closest relatives of 50 patients with presenile or senile dementia of the Alzheimer type. The disturbances most frequently reported were: wandering/pacing (56%, cumulative percentage), aggressive behavior (44%) and - significantly related to more severe stages of dementia - apathy/loss of drive (58%), eating disturbances (46%) and disturbances of the sleep-waking cycle (32%). ⋯ Signs of paranoid delusions (46%), delusional misidentification (34%), visual (32%) and auditory hallucinations (16%) were encountered temporarily in a large number of patients. The importance of "non-cognitive" symptoms in Alzheimer's disease is underlined by their subjective significance for the caregivers.
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In 12 of 32 elderly (> 65 years) hypertensives admitted with syncope, a diagnosis of orthostatic hypotension was made after a positive orthostatic tolerance test and extensive diagnostic evaluation with exclusion of other causes of syncope. Blood pressure of these 12 patients (pts.) after admission was 145 +/- 16/83 +/- 6 mmHg; at that time the pts. were treated with 2.6 +/- 1.6 different antihypertensive agents, and 67% of the pts. received a combination therapy. ⋯ Three months after discharge 91% of pts. remained free of a new syncope. Orthostatic hypotension is a frequent cause of syncope in the hypertensive elderly; thus, their blood pressure should be checked more often in the sitting and standing position and by ambulatory monitoring.