Pseudodementia in Schizophrenia and Mania

1988 ◽  
Vol 22 (1) ◽  
pp. 109-114 ◽  
Author(s):  
J. Murray Wright ◽  
Derrick Silove
Keyword(s):  
Cognitive Impairment ◽  
Old Age ◽  
Clinical Utility ◽  
Late Onset ◽  
The Elderly ◽  
Early Stages ◽  
Functional Psychoses

The importance of differentiating depressive pseudodementia from true dementia seems to be well recognized by psychiatrists, yet there seems less recognition that other functional psychoses in the elderly can present with symptoms of cognitive impairment. In this report, we describe two patients - one suffering from late onset schizophrenia and one from a manic illness - who were diagnosed as suffering from dementia in the early stages of their illnesses. We discuss some of the difficulties in making diagnoses in these cases which include an historical tendency for clinicians, including psychiatrists, to assume an organic aetiology for first presentation psychoses in old age. Although the concept of pseudodementia has been criticised in recent years, we conclude that it retains its clinical utility in that it orientates the clinician to the importance of recognizing treatable functional psychoses in the elderly.

Treatment of psychoses in the elderly

1996 ◽  
Vol 2 (3) ◽  
pp. 133-139
Author(s):  
A. Phanjoo
Keyword(s):  
Old Age ◽  
Psychotic Disorders ◽  
De Novo ◽  
Late Onset ◽  
Late Life ◽  
The Elderly ◽  
Functional Psychoses ◽  
First Time ◽  
Paranoid Psychosis

Psychotic disorders in the elderly can be divided into three types: disorders that have started in earlier life and persist into old age; disorders that start de novo after the age of 60, and psychoses associated with brain disease, including the dementias. The classification of psychoses in late life has provoked controversy for nearly a century. The debate concerns whether schizophrenia can present at any stage of life or whether functional psychoses, arising for the first time in late life, represent different illnesses. The nomenclature of such disorders consists of numerous terms including late onset schizophrenia, late paraphrenia, paranoid psychosis of late life and schizophreniform psychosis. This plethora of terms has made research difficult to interpret.

scholarly journals Assessment of judgment ability in a Brazilian sample of patients with mild cognitive impairment and dementia

2021 ◽  
Vol 15 (2) ◽  
pp. 200-209
Author(s):  
Patrícia Helena Figueirêdo do Vale-Britto ◽  
Laura Rabin ◽  
Livia Spindola ◽  
Ricardo Nitrini ◽  
Sonia Maria Dozzi Brucki
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Utility ◽  
Area Under The Curve ◽  
The Elderly ◽  
Relevant Information ◽  
Practical Judgment ◽  
Brazilian Sample ◽  
Everyday Problems

ABSTRACT. Judgment is the ability to make sound decisions after consideration of relevant information, possible solutions, likely outcomes, and contextual factors. Loss of judgment is common in patients with mild cognitive impairment (MCI) and dementia. The Test of Practical Judgment (TOP-J) evaluates practical judgment in adults and the elderly, with 15- and 9-item versions that require individuals to listen to scenarios about everyday problems and report their solutions. Objective: Adaptation of TOP-J for a Brazilian sample, preparation of a reduced version and verification of the accuracy of both. Methods: Eighty-five older adults, including 26 with MCI, 20 with Alzheimer’s disease (AD), 15 with frontotemporal dementia behavioral variant (FTDbv) and 24 controls, underwent neuropsychological assessment including the Brazilian adaptation of the TOP-J (TOP-J-Br). Results: On both TOP-J-Br versions, controls outperformed MCI, AD and FTDbv patients (p<0.001) and MCI outperformed AD and FTDbv (p<0.001). For the TOP-J/15-Br, the best cutoff for distinguishing controls and patients had a sensitivity of 91.7%, specificity of 59.0% and area under the curve of 0.8. For the TOP-J/9-Br, the best cutoff for distinguishing controls and patients had a sensitivity of 79.9%, specificity of 72.1% and area under the curve of 0.82. Conclusion: The TOP-J/15-Br, and particularly the TOP-J/9-Br, showed robust psychometric properties and the potential for clinical utility in Brazilian older adults at various stages of neurodegenerative cognitive decline.

scholarly journals Dementia in schizophrenia

2012 ◽  
Vol 18 (2) ◽  
pp. 144-153 ◽  
Author(s):  
Raghavakurup Radhakrishnan ◽  
Robert Butler ◽  
Laura Head
Keyword(s):  
Cognitive Impairment ◽  
Old Age ◽  
Early Onset ◽  
Late Onset ◽  
Evidence Base ◽  
Common Type ◽  
Future Research ◽  
Early Onset Schizophrenia ◽  
Growing Body ◽  
Diagnosis Of Dementia

SummaryA growing body of evidence suggests that the most common type of dementia in schizophrenia differs from Alzheimer's disease in its clinical features, natural course, neuropathology, neuroanatomical substrates and prognosis. Furthermore, there is some evidence that the risk of developing cognitive impairment and its progression in early-onset schizophrenia differ compared with late- or very-late-onset schizophrenia. The diagnosis and management of dementia in schizophrenia is challenging for both general adult and old age psychiatrists. This article reviews the evidence base regarding dementia in schizophrenia. It discusses the diagnosis of dementia in schizophrenia, its management and prognosis, and identifies some future research opportunities.

scholarly journals screening for cognitive impairment in late onset depression in a Brazilian sample using the BBRC-edu

2012 ◽  
Vol 6 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Tânia Maria da Silva Novaretti ◽  
Marcia Radanovic ◽  
Ricardo Nitrini
Keyword(s):  
Cognitive Impairment ◽  
Verbal Fluency ◽  
Late Onset ◽  
Digit Span ◽  
The Elderly ◽  
Control Group ◽  
Brazilian Sample ◽  
Depressed Patients ◽  
Healthy Elderly ◽  
Better Than

ABSTRACT Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective: To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods: We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results: For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion: Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.

scholarly journals Description Of Mental Status In Elders PSLU Tulungagung

2014 ◽  
Vol 1 (2) ◽  
pp. 135-139
Author(s):  
Nopia Riana Dewi
Keyword(s):  
Cognitive Impairment ◽  
Life Cycle ◽  
Old Age ◽  
Mental Status ◽  
Final Stage ◽  
Health Workers ◽  
Human Life ◽  
Sampling Technique ◽  
The Elderly ◽  
Descriptive Study

Old age is the final stage of the human life cycle and will inevitably be experienced by every individual, who will undergo physical and mental changes. The purpose of this study was to describe the mental status of the elderly. Method: Research design was descriptive study. The population in this study is 80 elders who live in PSLU Tulungagung in March 2014, Sample were 45 elderly by using purposive sampling technique. The data collected by  using a questionnaire MMSE at May 18th until 19th, 2014. Results: The result showed that 53.3% no cognitive impairment, 20% and cognitive impairment was 26.7% experiencing severe cognitive impairment. Discussion: It is expected that the results of this study, health workers improve activities that are motivating and supporting the elderly in dealing with elderly dementia or memory to support the mental status of the elders.

Different Sides of Depression in the Elderly: An In-depth View on the Role of Aβ Peptides

2021 ◽  
Vol 28 ◽  
Author(s):  
Giovann Pagni ◽  
Claudia Tagliarini ◽  
Manuel Glauco Carbone ◽  
Bruno Pietro Imbimbo ◽  
Donatella Marazziti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Late Onset ◽  
Amyloid Β ◽  
The Elderly ◽  
High Plasma ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Prodromal Phase ◽  
Aβ Peptides

Background: Late-onset depression (LOD) is the most common neuropsychiatric disorder associated with Alzheimer's disease (AD), often associated with structural and functional brain changes, neuropsychological impairments and negative family history for affective disorders. LOD could be a risk factor or a prodromal phase of AD; this has led to the investigation of the link between depression and amyloid-β (Aβ) peptides by measuring Aβ levels in plasma, cerebrospinal fluid (CSF) and brains of elderly depressed subjects. Objective: Clarify the complex relationship between depression, Aβ peptides and AD. Method: We evaluated all articles published up to 2019 in PubMed in which Aβ was measured in serum (or plasma), CSF or brain in elderly with Major Depressive Disorder or depressive symptoms evaluated with standard scales. Results: Low plasma Aβ42 levels are strongly associated with depression severity. Plasma Aβ40 levels are higher in younger depressed, drug-resistant and those with more severe symptoms. CSF Aβ42 levels are lower in depressed than controls. PET-detected global and region-specific increases in Aβ deposition are sometimes associated with LOD, cognitive impairment, anxiety but not with Cardiovascular Diseases (CVDs)/CVD risk factors. Elderly depressed with CVDs/CVD risk factors have more frequently high plasma Aβ40 levels and drug-resistance; those without these co-morbidities have low plasma Aβ42 levels and a greater cognitive impairment. Conclusion: Two specific Aβ profiles emerge in elderly depressed. One is associated with Aβ42 reductions in plasma and CSF, possibly reflecting increased brain amyloid deposition and prodromal AD. The other one is characterized by high plasma Aβ40 levels, cerebrovascular disease and clinically associated with increased AD risk.

‘Strength in What Remains Behind’: Wordsworth and the Question of Ageing

Romanticism ◽  
2019 ◽  
Vol 25 (3) ◽  
pp. 261-270
Author(s):  
Mark Sandy
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Frequent Pattern ◽  
Younger Generation ◽  
Old Men ◽  
Poetic Vision

Attending to the hoped-for connection between young and older generations, this essay revisits Wordsworth's poetic fascination with the elderly and the question of what, if any, consolation for emotional and physical loss could be attained for growing old. Wordsworth's imaginative impulse is to idealise the elderly into transcendent figures, which offers the compensation of a harmonious vision to the younger generation for the losses of old age that, in all likelihood, they will themselves experience. The affirmation of such a unified and compensatory vision is dependent upon the reciprocity of sympathy that Wordsworth's poetry both sets into circulation and calls into question. Readings of ‘Simon Lee’, ‘I know an aged Man constrained to dwell’, and ‘The Old Cumberland Beggar’ point up the limitations of sympathy and vision (physical and poetic) avowed in these poems as symptomatic of Wordsworth's misgivings about the debilitating effects of growing old and old age. Finally, Wordsworth's unfolding tragedy of ‘Michael’ is interpreted as reinforcing a frequent pattern, observed elsewhere in his poetry, whereby idealised figures of old men transform into disturbingly spectral second selves of their younger counterparts or narrators. These troubling transformations reveal that at the heart of Wordsworth's poetic vision of old age as a harmonious, interconnected, and consoling state, there are disquieting fears of disunity, disconnection, disconsolation, and, lastly, death.

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