Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A complex antiaging formula--Antagonic-Stress--was investigated vs. placebo (PL), meclofenoxate (MF)--neurometabolic nootropic and vs. nicergoline (NE)--cerebral vasodilator by comparative multiple trials (double-blind, randomized, and parallel) in gerontopsychiatry (DSM-III-R, 1987 and ICD-10, 1992 criteria). AS vs. PL studies in organic mental disorders--amnestic, depressive, anxiety, associated with axis III physical disorders or conditions, and in multiinfarct dementia were followed by AS vs. MF or NE investigations in senile dementia of Alzheimer's type. A total of 343 old people, distributed in 4 PL groups, 1 MF group, 1 NE group, and 5 AS groups were studied. Multiple investigations, before and after three-month treatments were made: psychometric evaluation by Sandoz Clinical Assessment-Geriatric, Self-Assessment Scale-Geriatric and their 5 subscales; psychopathological rating by Hamilton Depression and Anxiety Scales; as well as psychometric testing by digit symbol of WAIS, Wechsler Memory Scale and Wechsler Adult Intelligence Scale (WAIS). Except PL, prolonged and large dose treatments with these cerebral activators (MF, NE and especially AS) reduced the psychogeriatric-psychopathological scores and the deterioration index, and improved cognitive performance. The therapeutical effectiveness of AS multiple formula in gerontopsychiatry and its superiority vs. monotherapy (MF or NE) are discussed in connection with its complex neurometabolic and synergetic composition, multiple antioxidative combinations, free radical scavengers, lipofuscinolytic agents, the antiischemic action of antioxidants, multivitamin and multimineral supplementation, and with the better efficacy of multitherapy vs. monotherapy in geriatrics.
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PMID:Antagonic-stress. A new treatment in gerontopsychiatry and for a healthy productive life. 803 Aug 48

The diagnosis of dementia is a clinical one that can only be made with the rigorous use of clearly defined diagnostic criteria in an interview setting. The diagnosis cannot be made by laboratory tests or imaging techniques alone. In the elderly, a number of other psychiatric syndromes must be distinguished from dementia, including delirium, psychosis, depression, and mania. Sometimes it is not possible to make this distinction with confidence. Most dementias are caused by Alzheimer's disease or multi-infarct dementia, and the probable etiologic diagnosis can be made fairly quickly. However, a number of etiologies are possible, and some patients require extensive study. Some uncertainty is usual in the diagnosis of the living patient because routine brain biopsy is not feasible. Geropsychiatric and neurologic consultants can be helpful in selected cases.
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PMID:Clinical evaluation of dementia. 812 31

The shape and thickness of the third ventricles were studied with magnetic resonance imaging in 46 patients under evaluation for memory impairment. We compared this population with 23 subjects imaged for other reasons. The study group consisted of patients with diagnoses of probable dementia of the Alzheimer's type (DAT; 35.6%), multi-infarct dementia (MID; 22.2%), depression (8.9%), alcoholic dementia (6.7%), other dementias (OD; 13.2%) and no dementia (6.7%). Within the study group, there were no significant differences across diagnostic categories for duration of symptoms or level of education. Patients with DAT were, however, more impaired than others (Mini-Mental State Examination scores: DAT 14.6 [+/- 8.2] versus MID 17.4 [+/- 6.2] versus OD 21.2 [+/- 6.4]). Demented subjects were more likely than nondemented individuals to have a convex third ventricle and greater wall separation. The results suggest that the shape of the third ventricle may correlate with dementia. Possibly, the dorsal medial nucleus of the thalamus is involved in the dementia.
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PMID:Convex third ventricle: a possible sign for dementia using MRI. 825 Oct 50

The aim of this study was to evaluate whether follow-up measurements of regional cerebral blood flow (rCBF) by single-photon emission computed tomography (SPECT) provide additional information in the differential diagnosis of dementia. Thirty-six patients (70 +/- 14 yr) with suspected dementia who had two technetium 99m-hexamethylpropyleneamineoxime SPECT scans over 18 +/- 7 months were included in this retrospective study. The patients comprised three groups based on the final clinical diagnosis: (1) neurodegenerative disorder (NDD) including Alzheimer's disease (AD) (n = 13), frontotemporal lobe dementia (n = 2), progressive supranuclear palsy (n = 1), and mixed dementia (AD plus multiinfarct dementia [MID]) (n = 3); (2) MID (n = 8); and (3) psychiatric disorders (depression [n = 7], psychosis [n = 1], and anxiety [n = 1]). Blinded to the clinical diagnosis and using visual analysis, the nuclear medicine physicians compared the second scan with the first scan for each patient to characterize temporal changes in rCBF. SPECT findings were categorized into three patterns of rCBF change: worsened, improved, and unchanged. Of the worsened rCBF group, 17 (85%) belonged to the NDD group whereas 2 (10%) and 1 (5%) belonged to the MID and psychiatric disorders groups, respectively. All 5 (100%) of the improved rCBF patients belonged to the psychiatric disorders group. Thus, worsening of rCBF favors the diagnosis of NDD whereas improvement in rCBF may mitigate against the diagnosis of NDD or MID. Follow-up rCBF measurements by SPECT thus provided additional information on the possible cause of dementia. A prospective study to further evaluate the usefulness of follow-up rCBF measurements by SPECT appears warranted.
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PMID:Usefulness of follow-up regional cerebral blood flow measurements by single-photon emission computed tomography in the differential diagnosis of dementia. 855 59

The objective was to investigate the clinical and psychometric differences between patients with dementia of Alzheimer type (DAT) and patients with multi-infarct dementia (MID), matched for age, sex, education, and severity. Sixteen patients with DAT, 16 patients with MID, and 30 healthy individuals, were drawn from a longitudinal study on aging and dementia. Subjects with medical or previous mental disorders were excluded. DAT and controls with focal brain abnormalities on magnetic resonance imaging (MRI) were excluded. Diagnosis of dementia was carried out according to DSM-III-R criteria. Dementia severity was staged using the Clinical Dementia Rating (CDR) scale, and only patients with a score of 0.5-1 on CDR were studied. The main outcome measures were quantitative clinical scales of the assessment of global mental status, depression and anxiety, as well as a wide battery of neuropsychological tests for the evaluation of executive/conceptual functions and memory, as well as attention verbal ability, and visuospatial skill functions. The performance of demented patients compared to normal controls was affected on all measurements except for depression and anxiety. DAT patients showed compared to MID patients a greater extent of impairment on tasks assessing verbal comprehension and memory while MID patients were more significantly impaired on measures of frontal lobe functioning. Clinically matched DAT and MID patients show a differential pattern of neuropsychological impairment when studied in an early stage of dementia and with a mild degree of severity. Such patterns might be of value for the development of clinical diagnostic criteria.
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PMID:Patterns of neuropsychological impairment in mild dementia: a comparison between Alzheimer's disease and multi-infarct dementia. 875 Jan 7

It was the aim of the present study to evaluate the validity of the family history method in relatives of a sample of elderly subjects. A total of 201 relatives of patients and 89 relatives of control subjects were interviewed directly using the Composite International Diagnostic Interview and the Structured Interview for the Diagnosis of Dementia of the Alzheimer Type, Multi-infarct Dementia and Dementias of other Etiology. At least one relevant other could provide family history information on a respective subject. Family history information for psychiatric disorders including dementia (DSM-III-R) was neither accurate, nor sensitive (10 to 40%), but highly specific (> 95%). The sensitivity of the family history for dementia and depression increased in relation to the severity of the disorder. Relatives of patients were better informants than relatives of controls (at least for the presence of any psychiatric disorder). The use of several informants only slightly improved the sensitivity of the family history, without reducing the specificity to a significant extent. The combination of different sources of information may serve to reduce information biases. The evaluation of possible biases in future family studies is required to draw adequate conclusions from differences in familial loads.
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PMID:Validity of the family history method in relatives of gerontopsychiatric patients. 880 33

The aim of this study was to compare the performances on each item of the Mini-Mental State Examination (MMSE) of patients with Alzheimer's disease (AD) and multi-infarct dementia (MID). In order to identify the items that could better distinguish the two groups of patients, 70 AD and 31 MID patients matched for disease severity, age, and education were evaluated. The scores of the 101 patients on each of the MMSE items were entered into a principal component factor analysis using varimax rotation, and two main components were derived. Component 1 was probably representative of recently acquired information, whereas component 2 represented educational level. A score summing the items that loaded on component 1 and the recall item was calculated to generate a measure of episodic memory. Performing analysis of variance and covarying for age and education revealed that this score was statistically different in the two groups, with AD patients having lower values. The data suggest that the MMSE may demonstrate a pattern of impairment of memory that differs between AD and MID. Possible explanations of this finding should take into account the different neuroanatomical impairments and the different degrees of motivation, due to depression or attentional deficits, toward external stimuli.
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PMID:The Mini-Mental State Examination in Alzheimer's disease and multi-infarct dementia. 880 93

The aim of the present study was to evaluate the combined test-retest and interrater reliability of different psychiatric lifetime diagnoses yielded in the course of a family study in elderly patients and controls. The following interviews and questionnaires were used in combination: the Composite International Diagnostic Interview (CIDI), the Structured Interview for the Diagnosis of Dementia of the Alzheimer Type, Multi-infarct Dementia and Dementias of Other Aetiology (SI-DAM), the General Health Questionnaire (GHQ-12) and questionnaires for neurasthenia and recurrent brief depression (RBD). Depressive and dementia disorders can be diagnosed with good reliability in a family study setting with the use of these instruments. The diagnoses of phobic disorders, neurasthenia, RBD, subthreshold RBD and psychiatric caseness as indicated by GHQ-12 scores were less reliable in this setting and are therefore less suitable for use in family studies.
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PMID:Reliability of interview information in a family study in the elderly. 954 Mar 90

The relationship between suicide and dementia has not systematically been investigated, although the prevalence of both, dementia and suicide, increases with age. In contrast to patients with other psychiatric disorders, patients with dementia were not found to die from suicide more often than expected (SMR, 0). Thus the diagnosis of dementia does not contribute to the elevated suicide risk in old age. In studies using the psychological autopsy method, dementia was rarely diagnosed in suicide victims. Suicide attempts were observed in less than 1% of all patients with dementia. Depression as an important common risk factor of suicide and dementia is often found in patients with Alzheimer's disease (0% to 86%) as well as in patients with multi-infarct dementia (20% to 45%). However major depression was found significantly more often in vascular dementia than in dementia of Alzheimer type. Suicidal thoughts and intents, wishes to die and feelings that life is not worth living were reported in 1% to 42% of all patients with dementia, especially if these patients also suffered from depression. This review comprehensively presents the association between cognitive deficits, insight in early stages of dementia and suicidality and possible confounders which have not systematically been investigated up to now.
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PMID:[Dementia and suicide]. 1138 21

Cerebrovascular disease is the second most common cause of acquired cognitive impairment and dementia and contributes to cognitive decline in the neurodegenerative dementias. The current narrow definitions of vascular dementia should be broadened to recognise the important part cerebrovascular disease plays in several cognitive disorders, including the hereditary vascular dementias, multi-infarct dementia, post-stroke dementia, subcortical ischaemic vascular disease and dementia, mild cognitive impairment, and degenerative dementias (including Alzheimer's disease, frontotemporal dementia, and dementia with Lewy bodies). Here we review the current state of scientific knowledge on the subject of vascular brain burden. Important non-cognitive features include depression, apathy, and psychosis. We propose use of the term vascular cognitive impairment, which is characterised by a specific cognitive profile involving preserved memory with impairments in attentional and executive functioning. Diagnostic criteria have been proposed for some subtypes of vascular cognitive impairment, and there is a pressing need to validate and further refine these. Clinical trials in vascular cognitive impairment are in their infancy but support the value of therapeutic interventions for symptomatic treatment.
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PMID:Vascular cognitive impairment. 1284 65


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