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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Failing memory is a common complaint in the elderly, with the underlying fear of degenerative disease, especially Alzheimer's disease. However, compared with cognitive test results, these subjective complaints are not correlated with any recognizable cognitive disorder. Other factors are involved, including depression or anxiety as well as the social setting, self-esteem and the negative connotation of aging, requiring careful analysis for correct management. Age-related memory impairment is however quite real, expressed by a wide range of symptoms which can be detected on various psychomotor memory tests. The challenge is to detect those patients complaining of failing memory who really have age-related memory impairment and among them those who might be expected to progress to a state of dementia. In clinical practice, the clinician must look for non-cognitive factors (underlying disease state, sensorial disorder, depression, anxiety, social problems) and discuss with the patient his/her degree of independence in everyday activities. For certain patients, psychometric tests, advocated by some authors as capable of detecting pre-dementia states, may be indicated. In general, patients who complain of failing memory, who are not independent for certain everyday instrumental activities (telephone, transportation services, budget, medications) and who do not respond to clues on learning tests may be particularly susceptible to developing Alzheimer's disease.
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PMID:[Memory complaints in the elderly: a step towards dementia?]. 981 94

The term "mild cognitive impairment" refers to cognitive deficits which exceed normal physiological aging processes, but do not fulfill the criteria for dementia. While recent studies indicate that the respective deficits can be reliably assessed, different diagnostic criteria have prevented a wide application of this diagnosis in clinical practice. The aims of the present study were (1) to assess the prevalence rates of four current diagnostic concepts and (2) to investigate mild cognitive impairment with respect to psychological and sociodemographic variables. Data from 202 probands recruited from the interdisciplinary longitudinal study on adult development were analyzed. On the time of examination, probands were between 60 to 64 years old and in a good health. The following prevalence rates were determined: 13.5% for age-associated memory impairment (AAMI), 6.5% for age-consistent memory impairment (ACMI), 1.5% for late-life forgetfulness (LLF), and 23.5% for aging-associated cognitive decline (AACD). Complaints of cognitive deficits were significantly correlated with higher scores on depression and neuroticism scales but with none of the neuropsychological measures. Reduced performance in neuropsychological tests was associated with a lower educational level and socioeconomic status. We conclude that the prevalence rates of mild cognitive impairment are highly dependent on the diagnostic criteria applied. In this respect the self-report of cognitive decline might be a less useful criteria. Longitudinal studies are warranted to further elucidate the predictive value of these diagnostic criteria.
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PMID:Prevalence of mild cognitive impairment in an elderly community sample. 985 Sep 14

The term "mild cognitive impairment" refers to cognitive deficits which exceed normal physiological aging processes, but do not fulfill the criteria for dementia. The prevalence rates of four current concepts were compared in a sample of 202 healthy 60-64 year-old participants recruited from the interdisciplinary longitudinal study on adult development and aging (ILSE). Furthermore, the relationships between cognitive deficits and psychological and sociodemographic variables were examined. The following prevalence rates were determined: 13.5% for age-associated memory impairment, 6.5% for age-consistent memory impairment, 1.5% for late-life forgetfulness and 23.5% for aging-associated cognitive decline. Subjective cognitive complaints did not correlate with results obtained from neuropsychological tests. Significant correlations were however found between subjective cognitive complaints and higher scores on depression and neuroticism scales. Significant correlations were also found between a reduced test performance and a lower educational level and socioeconomic status. Longitudinal studies are warranted to further elucidate the predictive value of these diagnostic concepts.
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PMID:[Mild cognitive deficit in the elderly. Results of a gerontologic study]. 985 19

The present study was undertaken to determine the effects of chronic flumazenil treatment alone and simultaneously with diazepam on acquisition performance in an active-avoidance task and on locomotor activity in rats. Flumazenil (5, 10 and 20 mg/kg) and diazepam (0,5, 1.0 and 2.0 mg/kg) were administered intraperitoneally to rats before each daily training session for 5 days. The baseline of avoidance performance was set to approximately 50% and responses were expressed as acquisition rate. Locomotor activity of the rats was simultaneously recorded but only following the first training session. Diazepam decreased acquisition rate between the dose range used. Flumazenil had no effect on the acquisition rate of naive rats but reversed low dose diazepam-induced learning and memory impairment. Diazepam induced locomotor depression within the same dose range that decreased acquisition rate. Flumazenil had no effect on locomotor activity, but reversed the locomotor depressant effect of diazepam. The striking contradiction with previous data that flumazenil has no effect on learning-memory processing is discussed.
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PMID:The effects of flumazenil on two way active avoidance and locomotor activity in diazepam-treated rats. 1008 27

Memory and metamemory functioning were studied among 30 adult patients suffering from major depression. The results indicate that, besides showing signs of cognitive slowing, the patients were especially vulnerable to visual memory impairment, whereas verbal, short-term memory, and recall by recognition were more often unaffected. The patients whose depression was characterized by physiological symptoms, such as loss of appetite and sleep disturbances, showed impairment in traditional short-term memory measures, whereas there was no firm connection between cognitive or behavioral depressive symptoms and memory functioning. The depressive patients' generalized view of their memory capability was strongly underestimated, whereas online metamemory accuracy by which one perceives and makes inferences about one's performance was adequate.
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PMID:Memory and metamemory functioning among depressed patients. 1037 15

Andropause, a syndrome in aging men, consists of physical, sexual, and psychologic symptoms that include weakness, fatigue, reduced muscle and bone mass, impaired hematopoiesis, oligospermia, sexual dysfunction, depression, anxiety, irritability, insomnia, memory impairment, and reduced cognitive function. Free testosterone levels begin to decline at a rate of 1% per year after age 40 years. It is estimated that 20% of men aged 60-80 years have levels below the lower limit of normal. Although the causal relationship between declining testosterone levels and development of andropause symptoms is not firmly established, administration of testosterone to this population resulted in improvements in many areas. Most studies to date focused on physical benefits of testosterone replacement and failed to assess psychologic symptoms rigorously. Preliminary data suggest that therapy may benefit elderly men with new-onset depression. Testosterone administration is not without problems, the most worrisome being the potential for increased prostate cancer risk. Despite this concern, a limited number of studies administered the hormone weekly for up to 2 years, with only mild increases in prostate-specific antigen over control values. Currently, insufficient evidence, primarily regarding psychologic safety and efficacy, exists to warrant general administration of testosterone to elderly hypogonadal men. Further clinical investigations of this therapy in men with low testosterone levels and andropause symptoms are justified and necessary.
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PMID:Testosterone and andropause: the feasibility of testosterone replacement therapy in elderly men. 1045 66

Mood disorders are common, recurrent and disabling illnesses which are frequently associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation and memory loss. The hippocampus provides negative feedback to the HPA axis and has an important role in key aspects of spatial and declarative memory. Thus, hippocampal dysfunction could account for both the memory impairment and neuroendocrine abnormalities found in mood disorders. The critical role of the hippocampus in declarative memory, emotional processing, and vulnerability to stress has been demonstrated in both animal and human studies. Cellular processes in the hippocampus including long-term potentiation, neurogenesis, and dendritic remodeling are currently areas of intense study. Human studies report cognitive impairment consistent with hippocampal dysfunction in depression, bipolar disorder, Cushing's disease, and in those individuals receiving exogenous corticosteroids. This review examines data on the role of corticosteroids in hippocampal remodeling and atrophy in patients with mood disorders. Interventions to prevent or reverse the damaging effects of corticosteroids on the hippocampus are discussed.
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PMID:Hippocampal remodeling and damage by corticosteroids: implications for mood disorders. 1048 30

Although cognitive dysfunctions in psychosis have classically been associated with schizophrenia, there is clinical evidence that some bipolar patients show cognitive disturbances either during acute phases or in remission periods. The authors critically review the data on cognitive impairment in bipolar disorder. The main computerized databases (Medline, Psychological Abstracts, Current Contents) have been consulted crossing the terms 'cognitive deficits', 'neuropsychology', 'intellectual impairment', 'mania', 'depression' and 'bipolar disorder'. Changes in the fluency of thought and speech, learning and memory impairment, and disturbances in associational patterns and attentional processes are as fundamental to depression and mania as are changes in mood and behavior. Moreover, a significant number of bipolar patients show persistent cognitive deficits during remission from affective symptoms. However, there are several methodological pitfalls in most studies such as unclear remission criteria, diagnostic heterogeneity, small sample sizes, absence of longitudinal assessment, practice effect and poor control of the influence of pharmacological treatment. Most studies point at the presence of diffuse cognitive dysfunction during the acute phases of bipolar illness. Most of these deficits seem to remit during periods of euthymia, but some of them may persist in approximately one third of bipolar patients. Methodological limitations warrant further research in order to clear up the relationship between neuropsychological functioning and clinical, demographic and treatment variables in bipolar disorder.
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PMID:Cognitive dysfunctions in bipolar disorder: evidence of neuropsychological disturbances. 1060 30

Although neuropsychological studies have consistently reported executive deficits in schizophrenia, studies of executive functions in depression have produced equivocal results. The aim of this study was to examine the profile and the specificity of the executive impairment and its association with memory performance in young patients with unipolar depression. We compared patients with depression to normal control subjects and schizophrenics. Twenty young inpatients with unipolar depression, 14 schizophrenics and 20 age-, education- and IQ-matched control subjects were assessed with a neuropsychological battery including: (1) verbal memory task; (2) frontal tasks (WCST, Cognitive Estimate, Verbal fluency, verbal and visuo-spatial span) and a new complex sorting test (Delis test). Depressed patients and schizophrenics exhibited executive deficits. Unlike schizophrenics, depressed patients did not show memory impairment. Deficits in several 'higher-level' functions combined to produce executive impairments in patients with depression including complex integration for concept formation, spontaneous cognitive flexibility and initiation ability. Impaired functions in schizophrenia and in depressed patients were similar but were differently related to clinical variables. The pattern of memory failure in our schizophrenics is believed to reflect retrieval and encoding deficits. Our findings highlight the heterogeneity of skills grouped under the term 'executive functions' that are vulnerable in depression or schizophrenia.
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PMID:Executive functioning and verbal memory in young patients with unipolar depression and schizophrenia. 1070 64

Alzheimer's disease is a cortical dementia with an insidious onset and relatively slow progression. In the early stages and throughout most of the disease, memory impairment is the primary problem. Any manifestation of psychiatric symptoms is generally secondary to the amnesia, the paramount symptom of early Alzheimer's disease. The psychiatric symptoms emanate from the memory impairment. Therefore, testing memory is essential. The first stage of Alzheimer's disease commonly is marked by anxiety and depression secondary to memory impairment, and delusions. In the second stage, delusions often become more bizarre. Impairment of visuospatial memory, improper advances, and obscene language begin to replace disinhibited behavior, often to the point of violence directed at others. Increasing agitation requires restraints. In the third and final stage, screaming, banging, and cursing are common features. Verbal and behavioral perseverations are very common. Fecal and urinary incontinence and gait apraxia are other features of the final stage, again with restraints often necessary. In addition to outlining the progression of Alzheimer's disease through these stages, this article summarizes the available pharmacotherapy for the various psychiatric manifestations of the illness prevalent at each stage.
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PMID:Psychiatric disorders associated with Alzheimer's disease. 1073 May 8


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