Computed Tomography in the Elderly

1986 ◽  
Vol 148 (1) ◽  
pp. 80-85 ◽  
Author(s):  
Jonathan M. Bird ◽  
Raymond Levy ◽  
Robin J. Jacoby

The clinical, psychometric, and computed tomographic (CT) status of previously fit elderly volunteers is described at follow-up for up to four years. A number of relationships were found between psychometric and CT scores, but a dementing group could not be determined on the basis of a single scan. However, a subtle reduction in cognition over time was significantly related to CT changes, and occurred in 10%. Larger ventricles were also found in a small sub-group, who developed late-onset depressive disorders; recent bereavement was related to ventricular size. Thus a single CT scan may not be a useful discriminatory test in early dementia, but a repeat demonstrating ventricular enlargement, is likely to be significant. In the elderly, cognitive and CT scan deterioration should not be expected unless a disease process is occurring; this may be indicated by subtle cognitive impairment or by late-onset depressive disorder.

2016 ◽  
Vol 130 (8) ◽  
pp. 706-711 ◽  
Author(s):  
O Hilly ◽  
E Hwang ◽  
L Smith ◽  
D Shipp ◽  
J M Nedzelski ◽  
...  

AbstractBackground:Cochlear implantation is the standard of care for treating severe to profound hearing loss in all age groups. There is limited data on long-term results in elderly implantees and the effect of ageing on outcomes. This study compared the stability of cochlear implantation outcome in elderly and younger patients.Methods:A retrospective chart review of cochlear implant patients with a minimum follow up of five years was conducted.Results:The study included 87 patients with a mean follow up of 6.8 years. Of these, 22 patients were older than 70 years at the time of implantation. Hearing in Noise Test scores at one year after implantation were worse in the elderly: 85.3 (aged under 61 years), 80.5 (61–70 years) and 73.6 (aged over 70 years;p= 0.039). The respective scores at the last follow up were 84.8, 85.1 and 76.5 (p= 0.054). Most patients had a stable outcome during follow up. Of the elderly patients, 13.6 per cent improved and none had a reduction in score of more than 20 per cent. Similar to younger patients, elderly patients had improved Short Form 36 Health Survey scores during follow up.Conclusion:Cochlear implantation improves both audiometric outcome and quality of life in elderly patients. These benefits are stable over time.


1983 ◽  
Vol 28 (2) ◽  
pp. 102-104 ◽  
Author(s):  
Martin G. Cole

Thirty-eight elderly patients with primary depressive illness (Feighner criteria) were followed up for 7–31 months. In the absence of persistent organic signs and severe physical illness, age of onset (first depressive episode after 60) but not age was significantly related to course of illness. Compared to early onset depressives, late onset depressives were more likely to remain completely well during the follow-up period and less likely to have frequent or disabling relapses.


1980 ◽  
Vol 136 (3) ◽  
pp. 270-275 ◽  
Author(s):  
Robin J. Jacoby ◽  
Raymond Levy

SummaryClinical and computed tomographic (CT) data on a consecutive series of 41 elderly patients with affective disorders are presented, and comparisons made with a group of 50 healthy controls. In both groups ventricular size increased with age, but only in the controls was there an age correlation with sulcal widening. Using clinical and radiological criteria, the prevalence of cerebrovascular disease in the patient group was 12 per cent. A sub-group of patients with enlarged ventricles emerged, whose first depression began later in life, and who at the time of this study were older and showed more ‘endogenous’ features than the remainder. It is suggested that this provides further evidence that organic cerebral factors may have aetiological significance in some depressions of old age.


2002 ◽  
Vol 181 (2) ◽  
pp. 135-137 ◽  
Author(s):  
R. G. McCreadie ◽  
R. Padmavati ◽  
R. Thara ◽  
T. N. Srinivasan

BackgroundSpontaneous dyskinesia and parkinsonism have been reported in never-medicated patients with schizophrenia but there has been no previous study of the natural history of these conditions.AimsTo determine the prevalence of spontaneous dyskinesia and parkinsonism in a group of never-medicated, chronically ill patients with schizophrenia on two occasions separated by an 18-month interval.MethodDyskinesia was assessed by the Abnormal Involuntary Movements Scale using Schooler and Kane criteria for its presence; parkinsonism by the Simpson and Angus scale; and mental state by the Positive and Negative Syndrome Scale for schizophrenia.ResultsThirty-seven patients were examined on two occasions. Nine (24%) had dyskinesia on both occasions, 12 (33%) on one occasion and 16 (43%) on neither occasion. Twenty-one (57%) had dyskinesia on at least one occasion. Thirteen patients (35%) had parkinsonism on at least one occasion.ConclusionsSpontaneous dyskinesia and parkinsonism fluctuate over time. The former was found on at least one occasion in the majority of patients. It is an integral part ofthe schizophrenic disease process.


Author(s):  
María del Carmen Moreno Sáez

“Impresiones en azul” se corresponde con el nombre genérico de varios talleres dentro de un programa de educación artística para personas con demencia temprana, realizados en el Centro de Referencia Estatal de Atención a Personas con Enfermedad de Alzheimer y otras Demencias, de Salamanca, dependiente del IMSERSO. El objetivo de este programa era evaluar si la implementación de actividades artísticas podía ser una estrategia eficaz para promover el bienestar y las capacidades psicosociales, cognitivas y de comunicación de las personas con demencia temprana y, en consecuencia, una manera de mejorar los sistemas de cuidado de los mayores con principios de demencia. Estos talleres consistieron en el desarrollo de una sencilla técnica fotográfica, combinada con nuevas tecnologías. La investigación psicosocial cualitativa fue la metodología utilizada, prevista en tres fases: diseño de las actividades, desarrollo y seguimiento de los mismos y análisis de las producciones artísticas de los asistentes. Las conclusiones a las que se han llegado se pueden resumir en las siguientes: la demencia no ha supuesto problema alguno para el desarrollo de los talleres, el interés demostrado por los pacientes ha sido significativo, obteniendo resultados positivos en relación con su bienestar psicosocial, se ha experimentado un incremento de la comunicación entre los asistentes, tanto en sus relaciones interpersonales, como en su proyección al exterior y, por último, merece la pena destacar los modelos que pueden ser desarrollados en el cuidado de las personas con demencia temprana.“Impressions in blue” is the generic name given to several workshops belonging to an Art Education program targeted to people with early dementia, carried out in the State Centre for the Attention to People with Alzheimer Disease and other Dementias, in Salamanca, dependent on the IMSERSO. The aim of this program was assessing if the implementation of artistic activities could be an efficient strategy for promoting wellbeing and psychosocial, cognitive and communication capacities in people with early dementias and, therefore, improve the caring systems for the elderly with early dementias. These workshops consisted on the development of a simple photographic technique, combined with new technologies. The psychosocial qualitative research was the chosen methodology and was organised in three phases: activities design, development, follow-up and analysis of the artistic productions done by the participants. The conclusions drawn can be outlined as follows: Dementia didn’t cause any problem while developing the workshops; the interest shown by the participants was remarkable, obtaining positive reactions in regard to their psycho-social wellbeing; it was observed an increase in communication amongst the participants, not only in their personal relationships but also in their contact with the outside; lastly, it is worth highlighting the models that can be developed in the early dementia care.


2020 ◽  
Vol 9 (11) ◽  
pp. 3665
Author(s):  
Dongmin Kim ◽  
Pil-Sung Yang ◽  
Gregory Y.H. Lip ◽  
Boyoung Joung

Atrial fibrillation (AF) is considered a risk factor for dementia, especially in the elderly. However, the association between the two diseases is not well identified in different age subgroups. The association of incident AF with the development of dementia was assessed from 1 January 2005, to 31 December 2013, in 428,262 participants from a longitudinal cohort (the Korea National Health Insurance Service-Health Screening cohort). In total, 10,983 participants were diagnosed with incident AF during the follow-up period. The incidence of dementia was 11.3 and 3.0 per 1000 person-years in the incident-AF and without-AF groups, respectively. After adjustment for clinical variables, the risk of dementia was significantly elevated by incident AF, with a hazard ratio (HR) of 1.98 (95% confidence interval [CI]: 1.80–2.17, p < 0.001), even after censoring for stroke (HR: 1.74, 95% CI: 1.55–1.94, p < 0.001). The HRs of incident AF for dementia onset before the age of 65 (early-onset dementia) and for onset after the age of 65 (late-onset dementia) were 2.91 (95% CI: 1.93–4.41) and 1.67 (95% CI: 1.49–1.87), respectively. Younger participants with AF were more prone to dementia development than older participants with AF (p for trend < 0.001). AF was associated with an increased risk of both early- and late-onset dementia, independent of clinical stroke.


2018 ◽  
Vol 28 (2) ◽  
pp. 144-149 ◽  
Author(s):  
Juliette Delmas ◽  
Jean-Marie Loustau ◽  
Sylvain Martin ◽  
Loïc Bourmault ◽  
Jean-Paul Adenis ◽  
...  

Purpose: Accurate and reproducible exophthalmometry is mandatory to diagnose and follow-up orbital patients, especially in Graves disease. However, many variations are described among the different commercially available exophthalmometers. Methods: Sixty patients, who underwent a cerebral computed tomography (CT) scan, were included. External prebicanthal segments (EPBCS) for right and left eyes (RE and LE), interorbital distance, and globe axial length were recorded by a first observer (O1), more experienced than a second (O2). Intraobserver and interobserver reproducibility were evaluated, using intraclass correlation coefficient (ICC) and Bland and Altman plots. Results: Concordance between each EPBCS measurement for each eye and CT scan biometry was moderate for the Luedde ruler for the 2 observers. For the Hertel exophthalmometer, concordance was moderate for O1 in the 2 eyes and moderate in RE but good in LE for O2. For the Mourits exophthalmometer, this concordance was very good in RE and good in LE for O1, and good whatever the eye for O2. Intraobserver (ICC varying from 0.75 to 0.95 for the 2 observers) and interobserver (ICC from 0.69 to 0.94) reproducibility were high, especially for the Mourits exophthalmometer. Bland and Altman plots showed underestimations when using the Luedde ruler, overestimations when using the Hertel exophthalmometer, and overestimation of small values and underestimation of high values when using the Mourits exophthalmometer when compared to CT scan biometry. Conclusions: We demonstrated great accuracy to CT scan biometry with 1-prism Mourits exophthalmometer, low accuracy with the Luedde instrument, and intermediate accuracy with the Hertel exophthalmometer, with fair intraobserver and interobserver reproducibility.


1989 ◽  
Vol 18 (3) ◽  
pp. 211-221 ◽  
Author(s):  
Kye Y. Kim ◽  
Linda A. Hershey

Depression and suicide are significant problems in the elderly, both in terms of their severity and their prevalence. It is particularly difficult to distinguish depression from early dementia, since elderly depressed patients often deny mood disorder and focus on their memory problems. This differential diagnostic dilemma is further complicated by the fact that 20 percent of Alzheimer-type dementia patients have moderate to severe depression. An even higher prevalence of depression can be seen in elderly patients with stroke or Parkinson's disease. Most all of the depressive disorders of the elderly are amenable to one form or combination of therapies: pharmacologic, electro-convulsive, or psychotherapy. Tricyclic antidepressants are often associated with adverse drug reactions in the elderly, so alternatives such as MAO inhibitors, alprazolam, bupropion and psychostimulants are currently being explored in this patient population.


2021 ◽  
Author(s):  
Garazi Labayru ◽  
Borja Camino-Pontes ◽  
Antonio Jimenez-Marin ◽  
Joana Garmendia ◽  
Jorge Villanua ◽  
...  

Abstract Background: Myotonic Dystrophy Type 1 (DM1) is a multisystemic disease that affects gray and white matter (WM) tissues. WM changes in DM1 include increased hyperintensities and altered tract integrity distributed in a widespread manner. However, the precise spatiotemporal changes are yet undetermined. Methods: MRI data were acquired from 8 adult- and late-onset DM1 patients and 10 healthy controls (HC) at two different timepoints over 9.06 years. Fractional anisotropy (FA) variations were assessed with Tract-Based Spatial Statistics. Transversal and longitudinal intra- and intergroup analyses were conducted, along with correlation analyses with clinical and neuropsychological data.Results: At baseline, reduced FA values were found in patients in the uncinate, anterior-thalamic, fronto-occipital, and longitudinal tracts. At follow-up, the WM disconnection was shown to have spread from the frontal part to the rest of the tracts in the brain. Furthermore, WM lesion burden was negatively correlated with FA values, while visuo-construction and intellectual functioning were positively correlated with global and regional FA values at follow-up.Conclusion: DM1 patients showed a pronounced WM integrity loss over time compared to HC, with a neurodegeneration pattern that suggests a progressive anterior-posterior disconnection. The visuo-construction domain stands out as the most sensitive neuropsychological measure for WM microstructural impairment.


1994 ◽  
Vol 164 (3) ◽  
pp. 297-304 ◽  
Author(s):  
Marco Piccinelli ◽  
Greg Wilkinson

We reviewed follow-up studies of adults with depressive disorders seen in psychiatric settings, and noted outcomes in terms of recovery, recurrence, and persistent depression, at six months, one year, two to five years, and ten or more years after an index episode of depression. Recovery increased with time: about half recovered at least briefly by six months, and a large majority did so in the long term. Only about a quarter recovered from an index episode and remained well more than ten years thereafter. A quarter of patients suffered recurrence of depression within a year of an index episode, and three-quarters did so at least once during follow-up periods lasting more than ten years. For more than one in ten patients, the depression proved persistent, the proportion affected remaining relatively stable over time. The review highlighted a relative paucity of conclusive investigations on the outcome of the commonest psychiatric disorder in clinical settings.


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