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Query: UMLS:C0002395 (
Alzheimer's disease
)
110,584
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Three studies were conducted on elderly patients with dementia. A case of control study on life styles before falling ill revealed that "intake of sweets" was significantly associated with clinically diagnosed dementia of the
Alzheimer
's type. Evaluation of treatments of outpatients suggests that proper care and some kinds of neuroleptics are useful for alleviation of abnormal behavior such as agitation, wandering, hallucination,
insomnia
and depression, but not for improvement of cognitive function and memory. A study on caregivers of elderly demented patients was undertaken to determine the relationship between the components of burden and symptoms of patients.
Insomnia
and abnormal behavior of patients correlated with physical and mental components of the burden of caregivers. Memory disturbance, psychological symptoms and deterioration in ADL correlated with physical burden. These studies indicate that symptoms accompanying dementia such as
insomnia
, wandering, hallucination and agitation should be the treated intensively for the purpose of improvement of the quality of the lives of patients and caregivers.
...
PMID:[Prevention and treatment of dementia: what should we do today?]. 194 24
Sleep structure is qualitatively and quantitatively changed by aging. The elderly usually go to bed in early evening and wake up in early morning, and they also take several naps in the day time. The polyphasic sleep is one of the typical sleep patterns found in the elderly. Comparing the sleep of the elderly with that of young adults by the method of polysomnography, the characteristics of the sleep of the elderly are in the prolongation of sleep latency, shortening of total sleep time, increase of Stage W and Stage 1, decrease of Stage 3 and 4, and also decrease of Stage REM and the advance of REM phase.
Insomnia
is a frequently observed symptom in the elderly. The so-called psychophysiological
insomnia
due to transient psychological or situational stress is common in the elderly. However,
insomnia
following the mental disturbance (depression), chronic use of drug or alcohol, dementia (vascular or
Alzheimer
type) are also important in the elderly. Sleep apnea syndrome is recently found as an important cause of
insomnia
. Concerning the treatment and prevention of
insomnia
, it is necessary to exclude the causes of
insomnia
, to improve the environmental conditions and to keep the regular rhythm of sleep-wake cycle. It is also important to carefully select and use the adequate hypnotics considering the pharmacokinetics and adverse effects of the drugs in the elderly.
...
PMID:[Sleep disturbance in the elderly]. 219 Nov 61
Some studies suggest that abnormal behaviors are associated with increasing cognitive loss in
Alzheimer's disease
(AD). Other studies do not show this association. We examined the relation of cognitive loss, represented by Folstein Mini-Mental State Examination (MMSE) score, with abnormal behaviors in 680 patients with probable AD. Six behaviors were examined: agitation/anger, personality change, wandering, hallucinations/delusions,
insomnia
, and depression. All but depression were associated with declining MMSE score. The number of abnormal behaviors present in each patient was also related to declining MMSE score. Several other associations were also found: hallucinations/delusions were associated with age and race; agitation/anger was related to male gender; and wandering was associated with increased age. Although these data support the general notion that five of the six abnormal behaviors studied are more likely to occur with increasing cognitive loss, the correlations are small and it is suggested that other as yet unproven factors may play an as large or greater role than MMSE score in predicting such behaviors.
...
PMID:Relation of cognitive status and abnormal behaviors in Alzheimer's disease. 220 14
An 80-year-old retired teacher developed impairment of memory and suffered from delusions of theft. Four years later, she became disoriented as to person, time and situation, restless, began mutter to herself, and displayed night delirium and
insomnia
. She was subsequently diagnosed as having
senile dementia of the Alzheimer type (SDAT)
. She died of bronchopneumonia and multiple metastases from breast cancer at the age of 85 years. Family history was non-contributory. The brain weighed 1,020 g and showed diffuse atrophy. Histologically, there was moderate loss of neurons in the cerebral cortex, which was accentuated in the frontal and temporal lobes. In addition, numerous senile plaques were observed in the neocortex and hippocampus. Several senile plaques were also found in the amygdala, innominate substance, neostriatum, claustrum, thalamus, hypothalamus and tegmentum of the mesencephalon. Neurofibrillary tangles (NFTs) were mostly restricted to the hippocampus and parahippocampal gyrus, their number being compatible with the patient's age. No obvious neuronal loss was noted in the nucleus basalis of Meynert, neostriatum, substantia nigra or locus ceruleus, which are well known to be involved in
Alzheimer's disease
and
SDAT
. Recently, Terry et al proposed a new disease concept, "SDAT without neocortical NFTs". The histopathology of the cerebral cortex in our patient was very similar, if not identical, to those observed in their patients. However, the above authors did not mention any subcortical changes, leaving the detailed neuropathological picture unclear. Tentatively, we classified the present case as senile dementia with numerous neocortical senile plaques and preserved subcortical nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[An autopsy case of senile dementia with numerous neocortical senile plaques and preserved subcortical nuclei]. 259 44
We studied sleep patterns for three nights in 10 subjects with moderate to severe progressive supranuclear palsy and correlated the findings with disease severity using quantitative measures of motor, cognitive, and eye movement impairment. All subjects had severe
insomnia
, spending 2 to 6 hours awake per night; the mean time awake per night for the group was more than 4 hours. Sleep latency became shorter and the number of awakenings increased with greater motor impairment, and total sleep time declined as dementia worsened. These findings indicate that in progressive supranuclear palsy
insomnia
is related to disease severity.
Insomnia
associated with progressive supranuclear palsy appears to be worse than the
insomnia
of Parkinson's disease or
Alzheimer's disease
and may be due to degenerative changes in brain structures responsible for sleep maintenance.
...
PMID:Sleep abnormalities in progressive supranuclear palsy. 274 60
Alzheimer's disease
is a slowly progressive disorder involving deterioration of both intellect and personality. The neuropathological features of
Alzheimer's disease
include abundant neurocortical senile plaques and neurofibrillary tangles. Drug therapies of
Alzheimer's disease
have been based on empirical observations of the signs and symptoms of the disease and have included the use of hypnotics to reverse
insomnia
or inverse sleep rhythms; anxiolytics to relieve anxiety, tension and restlessness antipsychotics to "tranquilize" or control psychotic symptoms, such as delusions and hallucinations; stimulants to overcome withdrawn behavior or lethargy; and lastly, antidepressants to control depression. Our growing knowledge of neuropathological and neurochemical changes associated with normal aging and
Alzheimer's disease
has made it possible to explore and develop pharmacologically-based therapies in
Alzheimer's disease
. Recent research has revealed behavioral symptoms associated with underlying biochemical changes in either the cholinergic, dopaminergic/ GABAergic (gama-aminobutyric acid) noradrenergic, serotoninergic, neurochemical and/or neuropeptidergic systems. Pharmacological strategies involving manipulation of these systems as a means of relieving
Alzheimer's disease
symptoms will be reviewed from several perspectives, e.g., those involving transmitter substitution, enzyme inhibition and direct specific receptor stimulation.
...
PMID:Pharmacotherapy in Alzheimer's disease: basis and rationale. 354 Oct 49
Alzheimer's disease
(AD) primarily results in memory impairment and cognitive deficits in areas such as language, visuospatial function, calculation, praxis and judgement. However, over 30% of patients with dementia develop a group of secondary behavioural disturbances, including depression, hallucinations and delusions, agitation,
insomnia
and wandering. Because these secondary symptoms impair patients' function, increase their need for supervision, and often influence the decision to institutionalise them, the control of these symptoms is a priority in managing AD. Psychotropic drugs, particularly antipsychotics (neuroleptics), have been a mainstay in treating many of these symptoms, but carry a high risk of adverse effects. Patients with AD may be particularly vulnerable to adverse effects of medications because of changes in pharmacokinetics and neurotransmitter systems, related to both AD and aging. At present, treating secondary symptoms of AD is more of an art than a science. For virtually every group of symptoms, older and newer classes of medications are available, with proven efficacy in patients without dementia and less clear results in AD patients. We review current treatment options and suggest preferences for each symptom complex, based on a trade-off between efficacy and adverse effects. New agents, such as selective serotonin reuptake inhibitors and atypical antipsychotics, may herald the arrival of symptom- (and receptor-) specific drugs with minimal adverse effects.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Adjunctive therapy in patients with Alzheimer's disease. A practical approach. 757 86
Several factors have been reported to predict death and institutionalization in demented patients, even if the results of the studies are often conflicting. We conducted a study on a group of 86 consecutive noninstitutionalized probable
Alzheimer disease (AD)
patients, to evaluate clinical and social factors predicting mortality and institutionalization 1 year after discharge from the
Alzheimer
Dementia Unit at 'Sacro Cuore Fatebenefratelli' Hospital, Brescia, Italy. The 1-year mortality rate was 13.9% and the 1-year rate of admission to a nursing home was 34%. Our data indicate that the number of lost functions on the Activity of Daily Living scale is the most important predictor of short-term mortality, independently of the degree of cognitive impairment, the duration of the dementia, the age of the patients and the number of chronic diseases. Our data also demonstrate that, in a short period of observation, behavioral disturbances (and in particular
insomnia
) and availability of social services play a major role in the decision to institutionalize AD patients.
...
PMID:Predictors of mortality and institutionalization in Alzheimer disease patients 1 year after discharge from an Alzheimer dementia unit. 760 78
Alzheimer's disease
(AD) is a central nervous system disorder characterized by the presence of neurofibrillary tangles, neuritic plaques and dystrophic neurones in susceptible areas of the brain. Few options for treatment of AD symptomatology are available. We conducted a multicenter, randomized, double-blind, placebo-controlled, parallel trial consisting of a 90 day treatment period followed by a 30 day single blind placebo administration and by an optional long term period of treatment up to a year with idebenone in open fashion. Ninety two patients entered the study and nine of them dropped out before the first control. Treatment with idebenone was found effective on memory, attention, and orientation and in slowing down the natural progressive worsening of the disease. The most common side effects associated with this treatment were
insomnia
, gastralgia, nausea, and anxiety. However, all adverse effects were of mild intensity and did not require specific therapies.
...
PMID:Idebenone, a new drug in the treatment of cognitive impairment in patients with dementia of the Alzheimer type. 798 44
Alcoholism is a common disease in older patients, affecting up to 10% of those living at home and as many as 40% of those in nursing homes. Symptoms tend to be nonspecific, including "failure to thrive,"
insomnia
, diarrhea, and dementia. Morbidity and increased mortality can occur with no more than one or two drinks daily, because of altered pharmacokinetics with aging. Recognizing alcohol-induced brain injury, which can resemble
Alzheimer's disease
, is particularly important in the management of older patients. Withdrawal is more severe and prolonged than in younger patients and may require the judicious use of benzodiazepine therapy.
...
PMID:The older alcoholic: recognizing the subtle clinical clues. 810 Jul 95
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