Anti-Cholinergic Drugs and Memory: the Effects of Benzhexol on Memory in a Group of Geriatric Patients

1982 ◽  
Vol 140 (5) ◽  
pp. 470-472 ◽  
Author(s):  
G. Potamianos ◽  
J. M. Kellett
Keyword(s):  
Short Story ◽  
Senile Dementia ◽  
Digit Span ◽  
Word List ◽  
The Elderly ◽  
Learning Task ◽  
Elderly Subjects ◽  
Double Blind ◽  
Associate Learning ◽  
Immediate Recall

SummaryA double blind trial on the effects of 2 mg of benzhexol on memory was performed on thirteen elderly subjects without cognitive impairment. The tests given 90 minutes after the drug or placebo involved learning a list of ten words, a paired-associate learning task, learning a short story and a test of digit span. Subjects were asked to recall the word list one minute after an interfering task, and 6 items from the story directly. Digit span involved immediate recall and the paired learning was measured by the number of trials necessary to learn. All tests were significantly impaired by the benzhexol except for digit span. This suggests that muscarinic blocking drugs should be avoided in the elderly, as they mimic the memory deficits found in senile dementia of Alzheimer type.

Effects of acute tryptophan depletion on cognitive function in Alzheimer's disease and in the healthy elderly

2002 ◽  
Vol 33 (1) ◽  
pp. 41-49 ◽  
Author(s):  
R. J. PORTER ◽  
B. S. LUNN ◽  
J. T. O'BRIEN
Keyword(s):  
Cognitive Function ◽  
Rating Scales ◽  
Senile Dementia ◽  
Specific Effect ◽  
Acute Tryptophan Depletion ◽  
Elderly Subjects ◽  
Tryptophan Depletion ◽  
Emotional Symptoms ◽  
Double Blind ◽  
Healthy Elderly

Background. The cholinergic system is profoundly impaired in senile dementia of Alzheimer type (SDAT) and replacement therapy produces only modest clinical benefits. The serotonergic system is also impaired and may contribute both to cognitive and non-cognitive symptoms in SDAT. To investigate this further we assessed the effects of lowering brain serotonin using the technique of acute tryptophan depletion on cognitive function in patients with SDAT and in age matched control subjects.Method. Sixteen patients with probable SDAT and 17 healthy elderly subjects received two amino acid drinks in a within subject, double-blind, placebo-controlled, counterbalanced, crossover design. One of the drinks was nutritionally balanced and contained tryptophan (placebo), the other was identical but contained no tryptophan. A battery of detailed neuropsychological tests was performed between 4 and 6 h after the drink. Mood rating scales and other ratings of behavioural and emotional symptoms were also performed on both occasions.Results. Acute tryptophan depletion resulted in impairment on tasks of working memory in both groups. There was no group specific effect. Female SDAT subjects performed better on a task of pattern recognition during acute tryptophan depletion compared with placebo. There were no changes in behavioural symptoms during acute tryptophan depletion in either group.Conclusion. Compromised serotonergic function may be an important contributor to cognitive decline in SDAT and in ageing. Strategies targeting specific 5HT receptors may be helpful in SDAT.

scholarly journals Prevention of severe COVID-19 in the elderly by early high-titer plasma

2020 ◽  
Author(s):  
Romina Libster ◽  
Gonzalo Pérez Marc ◽  
Diego Wappner ◽  
Silvina Coviello ◽  
Alejandra Bianchi ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Primary Endpoint ◽  
High Titer ◽  
Controlled Trial ◽  
The Elderly ◽  
Elderly Subjects ◽  
Number Needed To Treat ◽  
Double Blind ◽  
Access To Treatment ◽  
Link Type

AbstractBackgroundTherapies to interrupt progression of early COVID-19 remain elusive. Among them, convalescent plasma in hospitalized patients was unsuccessful, perhaps because antibody should be administered earlier. We advanced plasma infusions to the first 72 hours of symptoms to arrest COVID-19 progression.MethodsA randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against SARS-CoV2 in elderly subjects within 72 hours of mild COVID-19 symptoms. The primary endpoint was severe respiratory disease defined as a respiratory rate ≥30 and/or an O2 sat<93% in room air. The study was interrupted at 76% of its projected sample size, because cases in the region decreased considerably and steady enrollment of study subjects became virtually impossible.Results160 patients underwent randomization. In the intention-to-treat analysis (ITT), 13/80(16.2%) patients receiving plasma vs. 25/80(31.2%) receiving placebo experienced severe respiratory disease [RR(95%CI)= 0.52(0.29,0.94); p=0.026)] with an RRR=48%.A modified ITT analysis, excluding six subjects who experienced the primary endpoint before infusion, showed a larger effect size [RR(95%CI) = 0.40(0.20, 0.81), p=0.007]. High- and low-titer donor analyses, based on a median IgG titer=1:3,200, evidenced a dose-dependent response with an RRR=73.3% for recipients of high-titer plasma (p=0.016) and a number needed to treat (NNT)=4.4. All secondary endpoints exhibited trends towards protection. No solicited adverse events were observed.ConclusionsEarly administration of high-titer convalescent plasma against SARS-CoV2 to mildly ill infected seniors reduced COVID-19 progression. This safe, inexpensive, outpatient intervention facilitates access to treatment from industrialized to LMIC, can decompress demands on hospitals, and may contribute to save lives.Funded by The Bill & Melinda Gates Foundation and The Fundación INFANT Pandemic Fund. Registered in the Dirección de Sangre y Medicina Transfusional del Ministerio de Salud (PAEPCC19), Plataforma PRIISA (1421), and clinicaltrials.gov (NCT04479163).All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; RL, GPM, DW and FPP are investigators in a phase 3 SARS CoV2 trial from Pfizer; no other relationships or activities that could appear to have influenced the submitted work.

An Overview of Fluoxetine in Geriatric Depression

1988 ◽  
Vol 153 (S3) ◽  
pp. 105-108 ◽  
Author(s):  
John P. Feighner ◽  
William F. Boyer ◽  
Charles H. Meredith ◽  
Gordon Hendrickson
Keyword(s):  
General Population ◽  
Plasma Concentrations ◽  
The Elderly ◽  
The Body ◽  
Elderly Subjects ◽  
Aging Brain ◽  
Efficacy And Safety ◽  
Geriatric Depression ◽  
Double Blind ◽  
Age Related

During the past 75 years, the proportion of elderly individuals in the USA has grown twice as fast as the general population. Depression in this age-group occurs four times more frequently than in the general population (Butler, 1975), and the suicide rate for people over 65 years of age is 15 times greater than that of the general population (Lehman, 1980).The elderly may be more susceptible to depression due to biological and/or psychosocial variables. Elderly people experience significant losses associated with increasing age, including death of spouse and friends, loss of work, social status, and physical and mental abilities (Lehman, 1980). The biogenic amine hypothesis suggests that the aging brain may experience a decrease in the functional availability of neurotransmitters (Lehman, 1980); this decrease may also play a role in the aetiology of depression.Due to age-related changes in the body, the elderly can be more sensitive to drug therapy. Older patients may require careful dosage adjustments and may also be more prone to experiencing drug-related adverse events. The elderly often receive medication for various indications, and drug interactions are a concern (Thompson et al, 1983). Therefore, efficacy and safety studies of new antidepressants in elderly patients are particularly important. We pooled data from both double-blind and open-label studies to evaluate the efficacy and safety of fluoxetine in geriatric outpatients with DSM-III major depression. Positive results of fluoxetine in the treatment of geriatric depression were reported in one of these studies (Feighner & Cohn, 1985). The favourable safety and side-effect profile of fluoxetine in the general population has been discussed elsewhere (Wernicke, 1985). Plasma concentrations of fluoxetine in elderly subjects are similar to those in younger individuals (I.emberger et al, 1985). These findings, combined with a lack of cardiovascular effects (Fisch, 1985), and low lethality with overdose, indicated promise for fluoxetine as a geriatric antidepressant.

Computed Tomography in the Elderly 2. Senile Dementia: Diagnosis and Functional Impairment

1980 ◽  
Vol 136 (3) ◽  
pp. 256-269 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy
Keyword(s):  
Senile Dementia ◽  
Clinical Signs ◽  
Cerebral Atrophy ◽  
The Elderly ◽  
Cognitive Test ◽  
Cortical Atrophy ◽  
Elderly Subjects ◽  
Computed Tomographic ◽  
Dementia Patients ◽  
Ct Data

SummaryClinical, psychometric and computed tomographic (CT) data are presented on three groups of elderly subjects: 50 normals, 40 patients with senile dementia and 41 suffering from affective disorder. Demented subjects showed significantly more CT evidence of cerebral atrophy than non-demented subjects, but there was considerable overlap. Although patients with a history or clinical signs of cerebral infarction were specifically excluded, such infarcts were found more often in CT scans of the dementia subjects than in the others, particularly when the diastolic blood pressure was raised. When correlating cognitive impairment with CT changes, ventricular size emerged as more important in the dementia patients, in contrast to the controls, in whom cortical atrophy was related to lower scores on a cognitive test. Other interesting findings included an inverse relationship between cortical atrophy and paranoid delusions.

scholarly journals Comparative study of the effects of two programs of physical exercises in flexibility and balance of healthy elderly individuals with and without major depression

2011 ◽  
Vol 9 (3) ◽  
pp. 307-312 ◽  
Author(s):  
Fernanda Varkala Lanuez ◽  
Wilson Jacob-Filho ◽  
Mariana Varkala Lanuez ◽  
Ana Cláudia Becattini de Oliveira
Keyword(s):  
Major Depression ◽  
The Elderly ◽  
Controlled Study ◽  
Elderly Subjects ◽  
Research Subjects ◽  
Double Blind ◽  
Elderly Individuals ◽  
Healthy Elderly ◽  
Physical Exercises ◽  
Balance Exercises

ABSTRACT Objective: To assess flexibility and balance in healthy elderly subjects with or without major depression, by means of two different programs: aerobic exercises and flexibility and balance exercises. Methods: A randomized, double-blind controlled study in which each sample was the control of itself. Research subjects were 19 healthy elderly individuals, aged between 60 and 90 years, of both genders, referred to the Department of Geriatrics of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, with or without the diagnosis of major depression, and sedentary or that had not engaged in physical activity for at least 6 months. Results: Subjects with major depression, as well as those without depression, showed signifcant improvement in flexibility and balance, especially in the group that did aerobic exercises. Conclusion: The results of this investigation reinforce the relevance of physical exercises for the elderly with major depression, as this is an important tool for treating and following-up this group of patients.

Effect of Sodium Valproate on Tardive Dyskinesia

1976 ◽  
Vol 129 (2) ◽  
pp. 114-119 ◽  
Author(s):  
M. Linnoila ◽  
M. Viukari ◽  
O. Hietala
Keyword(s):  
Tardive Dyskinesia ◽  
Sodium Valproate ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
The Elderly ◽  
Elderly Subjects ◽  
Gamma Aminobutyric Acid ◽  
Double Blind ◽  
Psychiatric State ◽  
Chronic Psychiatric Patients

SummaryThe effect of sodium valproate, a drug which has been demonstrated to increase gamma-aminobutyric acid levels in the CNS, on tardive dyskinesia and psychiatric symptoms was investigated in a double-blind cross-over study on 32 chronic psychiatric patients. The oro-facial dyskinesias were totally or significantly relieved in 17 cases. During the active treatment period the involuntary movements of the extremities and dystonic spasms were also significantly relieved in 7 out of 9 patients. In two patients, however, the extrapyramidal symptoms became slightly worse. A significant improvement was noted in the psychiatric symptoms of 14 out of 32 patients during sodium valproate administration. The psychiatric state of 4 out of 32 patients deteriorated. There was no correlation between the serum concentration of sodium valproate and its effect on the dyskinesia or on the psychiatric symptoms. Some of the elderly subjects showed a slight accumulation of the drug.

DHA supplementation improves cognitive function via enhancing Aβ-mediated autophagy in Chinese elderly with mild cognitive impairment: a randomised placebo-controlled trial

2017 ◽  
Vol 89 (4) ◽  
pp. 382-388 ◽  
Author(s):  
Yan-Ping Zhang ◽  
Yinyin Lou ◽  
Jing Hu ◽  
Rujuan Miao ◽  
Fei Ma
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Corn Oil ◽  
Digit Span ◽  
Controlled Trial ◽  
Intervention Group ◽  
Estimating Equation ◽  
Elderly Subjects ◽  
Double Blind

BackgroundHigher docosahexaenoic acid (DHA) intake is inversely correlated with relative risk of Alzheimer’s disease. The potential benefits of DHA supplementation in people with mild cognitive impairment (MCI) have not been fully examined.ObjectiveOur study aimed to assess the effect of a 24-month DHA supplementation on cognitive function and amyloid beta (Aβ)-mediated autophagy in elderly subjects with MCI.MethodsThis was a randomised, double-blind, placebo-controlled trial in Tianjin, China. A total of 240 individuals with MCI were identified and randomly divided into intervention (DHA 2 g/day, n=120) and control (corn oil as placebo, n=120) groups. Cognitive function and blood Aβ-related biomarkers were measured at baseline, 6, 12, 18 and 24 months. Data were analysed using generalised estimating equation.ResultsA total of 217 participants (DHA: 109, placebo: 108) completed the trial. During the follow-up, scores of full-scale IQ, verbal IQ and subdomains of information and digit span were significantly higher in the intervention group than the convention group (p<0.05). In the intervention group, blood Aβ-42 level and expression of Aβ protein precursor mRNA were decreased (p<0.05), while Beclin-1 and LC3-II levels and expression of LC3-II mRNA were increased (p<0.05).ConclusionDaily oral DHA supplementation (2 g/day) for 24 months may improve cognitive function and change blood biomarker-related Aβ-mediated autophagy in people with MCI. Larger longer-term confirmatory studies are warranted.Trial registration numberChiCTR-IOR-15006058.

Differences between young and elderly subjects in seasonal and circadian variations of total plasma proteins and blood volume as reflected by hemoglobin, hematocrit, and erythrocyte counts.

1986 ◽  
Vol 32 (5) ◽  
pp. 801-804 ◽  
Author(s):  
Y Touitou ◽  
C Touitou ◽  
A Bogdan ◽  
A Reinberg ◽  
A Auzeby ◽  
...  
Keyword(s):  
Blood Volume ◽  
Plasma Protein ◽  
Seasonal Variations ◽  
Plasma Proteins ◽  
Senile Dementia ◽  
Young Men ◽  
The Elderly ◽  
Elderly Subjects ◽  
Total Plasma ◽  
Circadian Variations

Abstract Circadian and seasonal rhythms in total plasma proteins were documented in healthy young men (around 24 years old), and in elderly subjects (both sexes), including senile-dementia patients in their eighties. The concentration of plasma proteins within a given group changed predictably (7-13%), depending on the hour of sampling and the season. Concentrations decreased noticeably around 04:00 h, then peaked around 08:00 h (shortly after waking). The 24-h mean concentrations of total plasma proteins were lower in the elderly groups than in the young men. But the seasonal variations of the 24-h mean values were strikingly larger in the elderly groups (7-8 g/L) than in the young men (2-5 g/L). Moreover, the circadian profiles of plasma proteins differed from the profiles of hematocrit, hemoglobin, and erythrocyte counts. Evidently, circadian variations of blood volume may not be the only element accounting for the variations of plasma protein concentrations. We suggest that the rhythms in plasma protein concentrations be taken into account when reference values are set. Circadian and seasonal variations in plasma proteins may also significantly affect the transport and binding of drugs, especially in the aged.

scholarly journals Dehydroepiandrosterone Treatment Is Not Beneficial to the Immune Response to Influenza in Elderly Subjects*

1997 ◽  
Vol 82 (9) ◽  
pp. 2911-2914
Author(s):  
H. D. Danenberg ◽  
A. Ben-Yehuda ◽  
Z. Zakay-Rones ◽  
D. J. Gross ◽  
G. Friedman
Keyword(s):  
Immune Response ◽  
Antibody Titer ◽  
Human Subjects ◽  
Serum Levels ◽  
The Elderly ◽  
Elderly Subjects ◽  
Double Blind Study ◽  
Double Blind ◽  
Age Related ◽  
Dhea Treatment

Abstract Background. Dehydroepiandrosterone (DHEA) is a native steroid with an immunomodulating activity that was suggested to counterregulate some phenomena of immunosenescence. Recently, it was shown to reverse the age-associated decline of immune response against influenza vaccine in aged mice. The present study was designed to evaluate the effect of DHEA on the immunization of elderly volunteers against influenza. Methods. Seventy-one elderly volunteers age 61–89 yr were enrolled in a prospective randomized, double-blind study to receive either DHEA (50 mg qd p.o. for four consecutive days starting two days before immunization) or placebo. Antibody response to the vaccine was measured before and 28 days after vaccination. Results. DHEA treatment significantly increased serum DHEA-sulfate (DHEA-S). No enhancement in established immunity was observed. A significant decrease in attainment of protective antibody titer (1:40 or higher) against the A/Texas strain in subjects with nonprotective baseline antibody titer was recorded following DHEA treatment compared with placebo (52% vs. 84%, P &lt; 0.05). Baseline DHEA-S serum levels were inversely related to attainment of immunization in DHEA-treated subjects. Influenza-like morbidity during the winter was low in the study group with no difference between the DHEA and placebo groups. Conclusions. Although highly effective in aged rodents, a short course of DHEA treatment did not improve the age-related declined response to immunization against influenza in human subjects. Higher baseline DHEA-S levels are not predictive of better immunization against influenza in the elderly.

Recall of a 10-Word List in the Assessment of Dementia in the Elderly

1982 ◽  
Vol 141 (5) ◽  
pp. 524-527 ◽  
Author(s):  
S. J. Harris ◽  
J. H. Dowson
Keyword(s):  
Recall Test ◽  
Paired Associate ◽  
Word List ◽  
The Elderly ◽  
Associate Learning ◽  
Alzheimer Dementia ◽  
New Information ◽  
Homes For The Elderly ◽  
History Of ◽  
Learning Test

SummaryResidents of homes for the elderly with a history of impaired memory compatible with senile Alzheimer dementia were assessed by a paired-associate learning test (PALT) and a word list recall test. The latter discriminated between groups of individuals categorized according to severity of cognitive impairment by the PALT. It may be suitable for the assessment of memory for new information in clinical practice and for the evaluation of change in clinical trials of treatments for dementia.

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