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

This study provided a comprehensive program to treat visual perceptual disturbances associated with right brain damage (RBD). Three types of previously evaluated perceptual remediation were integrated into a sequentially administered remediation program: basic visual scanning, somatosensory awareness and size estimation training, and complex visual perceptual organization. The purpose of the study was to evaluate the immediate (at rehabilitation discharge) and long-term (four months after discharge) effects of this treatment program on patients with RBD. The effects of treatment on ADL and mood state were also examined. Seventy-seven RBD stroke rehabilitation inpatients were studied--including 48 Experimental (E) and 29 Control (C). At rehabilitation discharge, the E group relative to the C group showed greater gains in all three types of perceptual functioning. Four months after discharge from rehabilitation, the C group continued to show gains in perceptual functioning while the E group had reached a plateau. Longitudinal decreases in levels of self-reported anxiety and hostility, but not depression, were noted only for the E group.
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PMID:Perceptual remediation in patients with right brain damage: a comprehensive program. 400 31

A method of assessing general (i.e. other than personal care) activities of stroke patients is described: the Frenchay Activities Index (FAI), a scale comprising 15 individual activities summed to give an overall score from 0 (low) to 45 (high). Data from 976 patients with acute stroke were analysed to establish the validity and reliability of the index, and to give information on the level of activities seen before stroke, at 6 months and 1 year post-stroke. Factors related to a lower overall score included loss of functional (ADL) ability, more depression, a lower IQ and, at 1 year, being female.
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PMID:Social activities after stroke: measurement and natural history using the Frenchay Activities Index. 409 49

In recent times the need for physical care of residents of Dutch old people's homes has clearly increased. This is strongly related to the ageing of the population of these homes as well as to the introduction of legal measures concerning the admission of new residents. Staff members have also noted an increase in the mental and social problems of residents. In this article we describe a rating scale devised for the assessment of psychosocial problems in a home for the aged. The staff completed this scale and an ADL scale four times at three-month intervals. The prevailing problems appear to be loneliness, isolation and depression. Longitudinal analysis indicates that the number of residents with physical and psychosocial problems is increasing. The relationship between these two domains however is relatively weak. This development requires a new orientation of management and staff and adaptation of education and training of personnel.
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PMID:[Nursing homes: a source of increasing concern. Behavior assessment by the nursing staff]. 664 20

In 91 stroke patients, the incidence of depression was 26% (24 patients) 6 months after stroke. Depression was significantly correlated with failure to resume premorbid social activities; depressed patients lost a mean of 67% previous activities while nondepressed patients lost a mean of 43% (p less than 0.01). Depression status was not significantly related to age, sex, marital or cognitive status, or side of brain involvement. Independence in ADL and ambulation or change in residence after stroke also were not significantly related to depression status. Since depression is common after stroke, is associated with failure to return to previous activities, and cannot be predicted by commonly used patient characteristics, the health care team must carefully identify, monitor, and manage depression in the patient recovering from stroke.
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PMID:Depression and failure to resume social activities after stroke. 708 55

Primary hyperparathyroidism is a not uncommon disease in the elderly. A prevalence of 3% for women and 1% for men is reported in subjects aged 65 years and over. Routine serum calcium determination and parathyroid hormone radioimmuno-assay allow to make an early diagnosis in still asymptomatic subjects. In the elderly the clinical features of the disease are often aspecific presenting with psychiatric and/or neuromuscular and/or cardiovascular disorders. This report refers to a 75 year-old woman admitted to our Department with a suspicion of senile dementia. She was affected by loss of memory, hallucinations, nausea, loss of appetite, mild polydipsia and polyuria. The patient was dependent in one activity of daily living (Index of Independence in Activities of Daily Living, ADL) and partially dependent in instrumental activities of daily living (Instrumental Activities of Daily Living Scale, IADL). The Short Portable Mental Status Questionnaire (SPMSQ) and the Geriatric Depression Scale (GDS) showed mild mental impairment and mild depression. Routine biochemical screening revealed a significant hypercalcemia. Parathormon assay and parathyroid scintigram were performed to confirm the diagnosis of primary hyperparathyroidism. After treatment of dehydratation and hypercalcemia, parathyroidectomy was performed: a single parathyroid adenoma was found and removed. On discharge the patient was lucid and able to carry out all ADLs and IADLs.
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PMID:[Neuropsychologic symptoms of primary hyperparathyroidism in the elderly. Report of a clinical case]. 773 70

We performed a prospective observational study using a stroke register, case-note review and survey of carers with 6 months of follow-up in two adjacent health districts in East London. District 1 was a teaching district and had no special stroke service; District 2 had a comprehensive stroke service comprising stroke unit, review of all stroke admissions and community follow-up. Three hundred and sixty-one consecutive patients with stroke admitted to hospital and 103 carers were surveyed at 6 months from admission using the Royal College of Physicians (London) Stroke Audit standards. We also assessed mortality, disability, perceived health, mood, and satisfaction with services 6 months after stroke, carer mood, perceived health and satisfaction with services. The standard of care was below that set by the Royal College of Physicians of London in both districts and there were no significant differences between the districts in age-standardized mortality at 1 and 6 months, Barthel score, extended ADL score, Geriatric Depression score, Nottingham Health Profile score and patient satisfaction with services at 6 months. Carer outcomes did not differ between districts. Service costs, particularly costs of rehabilitation services, were much lower in District 2. A comprehensive district stroke service was not associated with major differences in patient outcomes or standards of care. This may have been because the non-random nature of the comparison meant that the patients differed in other ways than in the nature of treatment. Caution is needed when using these techniques in making purchasing decisions.
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PMID:How useful are non-random comparisons of outcomes and quality of care in purchasing hospital stroke services? 779 36

The objective of this study was to determine the concurrent validity of a new rating scale for dependence of elderly people in residential homes (EBISZ). Care dependence was assessed by 5 items of ADL (dressing, bathing, using toilet, eating, getting around inside) and 5 items on special care (e.g., because of pressure scores), annoying behaviour, wandering, and language and memory impairment. Subjects were 212 elderly residents (mean age 84 years, sd = 6.3). The Pearson correlation between the new rating scale and a 12-item ADL-scale was 0.88. A multiple regression analysis with ADL, cognitive impairments, mood and behaviour problems, and social activities as independent variables, revealed that 2 variables (ADL and cognition) explained 83% of the variance in EBISZ. The new rating scale was relatively insensitive to problems of mood and social behaviour. The EBISZ missed more than 50% of the residents who needed special care because of depression or lack of social contacts. Dependence is a multidimensional concept. Its assessment should include ADL, mood, and social behaviour measures.
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PMID:[Care burden in nursing homes: uni- or multidimensional?]. 803 44

We assessed the mental health conditions of 217 subjects who took care of elders at home, using our depression scale by the surveillance of the elders living at home in Ibaraki Prefecture. An analysis was made on how depression in the caretakers was related with each item of demographical results of the caretakers and the elders living together at home, and with ADL, depression, dementia, personality change and the personality trait of the elders. Our study revealed that depression, personality change and the viscous character of the elders are three factors associated with depression in the female caretakers. Furthermore, we pointed out the necessity of an education campaign to provide the caretakers with information on the elders' personality and personality change for maintenance of the good mental health of the caretakers living with the elders.
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PMID:Mental health in family members living with elders. 820 91

Little is known about the degree of disability and quality of life of patients after major trauma. We conducted a prospective study to examine the incidence and predictors of functional limitation (FL). Between January 1, 1990 and March 30, 1990, 61 eligible trauma patients were enrolled in the study (admission GCS score > or = 12, LOS > 24 hours). Functional limitation after trauma was measured at discharge and 3 months after discharge using the Quality of Well-being (QWB) scale, a more sensitive index to the well end of the functioning continuum (range, 0 = death to 1.000 = optimum functioning). Functional limitation was also measured using a standard ADL scale (range, 17 = full function to 41 = maximum dysfunction). Risk factors measured were injury severity, body region, depression (CES-D) scale, and social support. Follow-up was achieved in 42 patients (70%). The mean age was 30 years, 74% were male, 52% white, 41% hispanic, and 3% other. The mean ISS was 15, with 69% blunt injuries and a mean LOS of 12 days. The QWB scores improved between discharge and follow-up; discharge mean = 0.457 (+/- 0.048), follow-up mean = 0.613 (+/- 0.118), but the mean QWB score at follow-up still reflected a significant degree of functional limitation. The mean percentage of change in QWB scores was 34.5% (+/- 25.5%) with a range of -6.34% to 103.8%. The discharge mean FDS was 29 (+/- 6.2) while the follow-up FDS mean was 17 (+/- 3.8), reflecting that most patients at follow-up reported near-perfect ADL functioning.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Functional limitation after major trauma: a more sensitive assessment using the Quality of Well-being scale--the trauma recovery pilot project. 829 53

The authors present their own experience with the use of the behavioural scale elaborated by Blessed, Tomlinson and Roth usually called Blessed Dementia Scale-BS. They examined 76 patients (59 dementia, 17 with major depression, aged 57 - 87 years (mean age 70.3 +/- 7.2 years). The results obtained by BS were compared with WAIS-R, Wechsler's memory scale (WMS) and the MSE cognitive scale (Knopman et al., 1985). They found that BS differentiates satisfactorily patients with dementia and major depression (dementia X = 8.16 +/- 5.4, depression X = 4.41 +/- 2.41, t = 4.07, p < 0,001). The results of examinations by means of BS correlate significantly inversely with the results of examinations of cognitive functions. The closest correlation is between the total BS score and MSE (r = -0.705, p < 0,001). It was confirmed that BS can be used in the diagnosis of dementia for the differential diagnosis of dementia and depressions. Evaluation of partial BS scores (associated with instrumental ADL, basic ADL and personality changes, drives and interests) provides information important for evaluation of the functional capacity of the patient and for the procedure after termination of in-patient treatment. It is important that the total BS score and the partial BS score is not influenced by the patients' age.
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PMID:[Use of behavioral scales in the diagnosis of dementia in the aged]. 864 Apr 88


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