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)

Elderly patients often manifest a variety of symptoms (e.g., depression, memory loss, irritability, hostility), categorized as "senility" or "senile dementia," which are difficult to treat and represent a major therapeutic challenge to the geriatrician. This investigation was designed to assess, under double-blind conditions, a drug often prescribed for these symptoms--cyclandelate. In a 16-week study, 58 elderly patients were randomly assigned to two groups and received either 1600 mg of cyclandelate daily or identical-appearing placebo capsules. Initially, the every four weeks thereafter, the patients were examined for changes in vital signs and for adverse reactions, also, the Sandoz Clinical Assessment-Geriatric (SCAG) Scale and the Nurses Observation Scale Inpatient Evaluation (NOSIE) were completed. At the final evaluation, a physician's global rating was obtained. Our data suggest that cyclandelate is a safe and moderately effective treatment for certain symptoms of senescence in carefully selected patients.
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PMID:Cyclandelate in the treatment of senility: a controlled study. 35 21

This study was designed to assess the effectiveness and the safety of nylidrin HCL in the geriatric patient and mild to moderate symptoms of cognitive, emotional and physical impairment. Following a 3 week placebo washout, 60 patients received either nylidrin HCL or placebo for 12 weeks. Efficacy evaluations were made utilizing the Sandoz Clinical Assessment Geriatric (SCAG) Scale, a nurse's rating of ward behavior (SCASNO), the Hamilton Psychiatric Rating Scale for Depression, and 2 of the Katz Adjustment Scales. Significant improvement in symptom severity was demonstrated in the nylidrin group as compared to the placebo group. There were no abnormalities of clinical significance in the safety measurements and few side effects were reported.
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PMID:Nylidrin HCL in the treatment of symptoms of the aged: a double-blind placebo controlled study. 50 May 75

The elderly tend to be more rigid than younger adults in their attitudes and personalities, and such rigidity is correlated with poor adjustment. However, the rigidity is not the cause of the poor adjustment; rather, it is an attempted solution. One of the patterns of rigidity is an outgrowth of the lifestyle of pessimism, suspicion, self-reliance, self-discipline, determination, and endurance. Two case studies are presented illustrating how rigidity can channel thoughts and prevent the brooding which works itself into depression or anxiety, while simultaneously reinforcing self-help behavior. Geriatric psychotherapy should be problem-centered and should not launch a frontal assault on rigidity or attempt to reconstruct the patient's personality. Behavioral modification, authority, and motivation slogans can be used in conjunction with the rigidity to improve the patient's coping ability.
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PMID:Geriatric rigidity and its psychotherapeutic implications. 65 69

Psychiatric evaluation as a part of the complete geriatric workup was done on 143 consecutive patients transferred to a Medical Geriatric Evaluation Unit. The patients' age ranged from 48 to 94 years. The findings were: free of psychiatric problems--19.1%; organic brain syndrome--58.8%; dysphoria-depression--36.8%; paranoid--3.7%; alcohol abuse--8.1%; marital maladjustment 18.3% (of marrieds). The Geropsychiatrist diagnoses, participates in psychiatric management, consults, and supervises psychiatric evaluation by other team members. He is an esential member of the Geriatric team since proper recognition and treatment of psychiatric problems is necessary to complete treatment and to make optimum disposition.
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PMID:Geriatric evaluation unit of a medical service: role of a geropsychiatrist. 75 90

Recent research indicates a possible cholinergic involvement in memory processes and thus the possibility that acetylcholine deficiency may underlie memory impairment in senile dementia. Deanol (2-dimethylaminoethanol), which is assumed to increase brain acetylcholine, was given openly for 4 weeks to 14 senile outpatients, to determine the safety of the drug and whether or not it reduces cognitive impairment. The dosage was gradually increased to 600 mg three times daily during the first two weeks, with no adverse effects. Ten patients improved globally and 4 were unchanged (p less than .01). The total score on the Sandoz Clinical Assessment-Geriatric (SCAG) was lowered by the third week (p less than .01), primarily as a result of reduced depression, irritability and anxiety, and increased motivation-initiative. However, neither the clinical ratings nor an extensive pre- versus post-treatment series of cognitive tests revealed changes in memory or other cognitive functions. Since a similar separate study with a different compound produced no behavioral changes, it is unlikely that the improvement with deanol was due entirely to placebo effects. The results thus suggest that although deanol may not improve memory, it may produce positive behavioral changes in some senile patients.
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PMID:Senile dementia: treatment with deanol. 86 68

Sensory deprivation speeds up the degenerative changes normally associated with aging and enhances the loss of functional cells in the central nervous system. Since it connotes reduction or absence of stimulation of the five senses, it involves the patient's physical activity, social relationships, intellectual status and overall "value system." Geriatric patients with various illnesses are particularly vulnerable to sensory deprivation, which becomes increasingly pronounced as physical or mental deterioration progresses. All cells require stimulation for continued growth and activity; lack of stimulation leads to atrophy, with secondary physical or psychosocial abnormalities. Depression acts as a negative reinforcement of stimuli, and anxiety acts as a blocking mechanism. The goal of rehabilitation is to maintain and strengthen the patient's social values and to preserve mental and physical motility. The recommended procedure involves assessment of medical, psychologic and social factors, and determination of whether organic disease is present. A specific treatment plan to meet the individualized needs of each patient is then established so as to minimize sensory deprivation and maximize physical and mental functioning. Re-evaluation (physical and psychologic) at regular intervals establishes a pattern not only for individual comparison but for comparison with results in untreated control groups.
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PMID:Sensory deprivation in geriatric patients. 96 76

Discriminant function analysis was employed to study the ability of the Geriatric Mental Status interview to distinguish between patients diagnosed by the project as having an organic brain syndrome or a functional psychiatric disorder. In both New York and London, patients with organic brain syndrome scored significantly higher (p less than 0.05) than those with functional disorders on the factors of impaired memory, disorientation and incomprehensibility and significantly lower on the factors of depression and somatic concerns. Discriminant functions calculated from data on the New York and London patients separately significantly distinguished not only the patients on whom the functions were based but the patients in the other sample as well.
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PMID:Distinctions between organic brain syndrome and functional psychiatric disorders: based on the geriatric mental state interview. 102 2

Because of the multiplicity of disease conditions and diminished tolerance for drugs in the aged, it is necessary to know concomitant pathologic conditions to determine which antihypertensive drug to use. In the Philadelphia Geriatric Center, there are about 1,000 residents, between 70 and 100 years of age. About 40% have hypertension; almost 50% have or once had depression; there are many cases of hiatal hernia and/or peptic ulcer; in one subdivision of residents, almost 40% have renal disease with BUN above 30 mg/100 ml. In antihypertensive treatment, some individuals respond fairly well to reassurance and weight reduction, when obese, even without drugs. All are given a low-salt diet. A diuretic is first used--thiazide in cases of good renal function, furosemide with impaired renal function. Liquid potassium supplements are given. If there is but little reduction in blood pressure in several weeks, methyldopa is added in ascending doses, in cases with or without renal impairment. In hypertension with impaired renal function, furosemide and/or methyldopa were especially valuable. Furosemide as an antihypertensive drug was also noted to delay the onset of congestive heart failure. Since reserpine can aggravate peptic ulcer and can precipitate or aggravate depression, it should seldom be used to treat hypertension in the aged. Guanethidine is rarely used, since it can cause cerebrovascular insufficiency and marked weakness. High blood pressure should be reduced slowly in the aged, to avoid untoward effects.
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PMID:An approach to the treatment of hypertension in the aged. 105 27

Geriatric patients who undergo intravenous sedation require careful intraoperative management, because respiratory and circulatory depression usually accompanies the administration of recommended adult sedative doses. This study examined results when a single benzodiazepine, diazepam or flunitrazepam, was carefully titrated to a clinical endpoint of conscious sedation. A total of 335 cases was divided into seven age groups. Mean sedative doses gradually decreased with age. The 60- to 69-yr group required about 75% of the adult recommended dose, the 70- to 79-yr group required 40% to 60%, and the 80- to 89-yr group required 30% to 45%. Pulse oximetry values also declined with age; respiratory depression was observed mainly in elderly patients. Declines in blood pressure after benzodiazepine administration were not correlated with age. The rise in blood pressure normally observed intraoperatively was suppressed both in young as well as old patients. We conclude that intravenous conscious sedation in elderly patients reduces stress-induced cardiovascular stimulation and that respiratory depression may occur at even low sedative doses.
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PMID:Responses to intravenous sedation by elderly patients at the Hokkaido University Dental Hospital. 130 76

The authors present a contribution to the french validation of the self-rating questionnaire of the depression in the elderly proposed by Yesavage and Brink (1982), the Geriatric Depression Scale (30 items). This study focusses on the assessment of the homogeneity and of the unidimensionality of this scale. 99 aged women living in old-people homes or attending a geriatric somatic day-hospital, not known to be psychiatrically ill, filled the GDS and were interviewed by either a psychiatrist or by a clinical psychologist. This interview yielded 44 cases of Major Depressive Disorder or of Dysthymia (DSM III). Firstly, we have applied the classical correlational methods of assessment of scale Reliability and Construct Validity: Cronbach's coefficient alpha and item-total correlations (homogeneity) and Principal Component Analysis (PCA) without rotation. Then, we have performed a Rasch Model Analysis: this method which belongs to the general frame of Latent Trait Theory relies on a probabilistic model of subject's response to individual questions. In the Rasch model, the response probability of a given subject to a given item is a logistic function of the difference between the item location parameter and the subject location parameter along a single continuous latent dimension. Our results have shown that the Cronbach's alpha was very high (.902) and that the item-total correlations were quite satisfactory (mean .470), thus giving a strong impression of homogeneity (similar to unidimensionality for many authors).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Study of the uni-dimensionality of the Yesavage-Brinck geriatric depression scale. Comparison between classical methods and Rasch's model]. 827 98


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