Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multi-infarct dementia (MID) and dementia of the Alzheimer type (DAT) are the main syndromes in the elderly. This study aims at evaluating the possible differentiation of these syndromes on a clinical basis. The patient population consisted of demented patients hospitalized during the period April 1, 1988-September 30, 1990 at the Department of Cerebrovascular Diseases. The study included 40 patients with MID and 25 with DAT. The clinical diagnosis of dementia included medical history, neurological examination, psychiatric interview and laboratory diagnostic investigations. The severity of the dementia symptoms was rated by many rating scales and a battery of neuropsychological tests. This model of clinical procedure permitted for differential diagnosis between vascular and degenerative dementia, according to DSM-III-R criteria. Patients with multi-infarct dementia of the Alzheimer type did not differ significantly with regard to age, mean duration of cognitive impairment and level of education. In the DAT group women outnumbered men, and this was statistically significant. It should be emphasized, that a great majority of patients with cerebrovascular lesions developed early cognitive impairment, that means within the first year after stroke. In the MID group hypertension, heart disease and smoking were statistically more frequent than in the DAT group. For the preliminary evaluation the severity of cognitive impairment was quantified by Mini-Mental State and Dementia Scale. These scales showed that the degree of dementia was significantly greater in DAT patients as compared to MID patients, whereas the severity of depression assessed by Hamilton's Scale was mild and similar in both group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and differential diagnosis of multi-infarct dementia and Alzheimer's disease]. 152 70

Moderate drinking for the elderly of both genders is no more than one drink per day, where a drink is defined as 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits. Age does not affect the rate of absorption or elimination of alcohol. Lean body mass decreases and adipose tissue increases with age, however, resulting in a corresponding decrease in the volume of total body water. With a smaller volume of distribution, an alcohol dose identical to that administered to a younger individual of the same size and gender will produce a higher blood alcohol concentration in the elderly. Low-dose alcohol stimulates appetite and promoters regular bowel function. In the well-nourished nonalcoholic elderly, the negative impact of alcohol consumption on nutrition is minimal. Alcohol consumption improves mood by increasing feelings of happiness and freedom from care while lessening inhibitions, stress, tension, and depression. Although in the laboratory low-dose alcohol improves certain types of cognitive function in young men, in other types of task performance, alcohol induces impairment, which worsens with age. The effects of alcohol on sleep are primarily detrimental, worsening both insomnia and breathing disturbances during sleep. Although the role of alcohol consumption in mortality from heart disease has not been investigated in the elderly, moderate drinking appears safe. Under some circumstances low-dose alcohol may produce analgesia whereas in others it may worsen pain. The elderly use a significant proportion of both prescription and over-the-counter medication, a large variety of which interact with alcohol. Alcoholic beverage consumption may exacerbate cognitive impairment and dementias of other etiology. Although some studies suggest that moderate use of alcohol by institutionalized senior citizens appears to produce benefits including improved socialization, separation of the effects of the social situation from those specifically attributable to alcohol remains to be accomplished. Older individuals who want to drink, have no medical contraindications, and take no drugs (prescription or over-the-counter) that interact with alcohol, may consider one drink a day to be a prudent level of alcohol consumption. Patients should be counseled to avoid alcohol consumption immediately prior to going to bed in order to avoid sleep disturbances. They also should be cautioned against potential drug-alcohol interactions and told to avoid alcohol ingestion prior to activities such as driving. The decision to recommend a particular level of alcohol consumption in any given patient must, however, be carefully tailored not only to that individual's specific medical needs but to his or her social and environmental circumstances as well.
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PMID:Alcohol and the elderly. 157 71

In 2793 respondents aged 65 and over in a survey of a geographically defined community, who were asked about falls in the preceding twelve months, the estimated annual prevalence rate (persons) of falls was 28.0%. Standardized for age, the rate was twice as high in women as in men. Rates increased with age but more steeply in men than in women. Compared with non-fallers, fallers had been in more recent contact with their general practitioner, showed higher prevalence of problems with mobility and daily living, a more frequent history of stroke and heart disease, and had more episodes of non-rotatory vertigo, double vision, faints and blackouts and episodes of weakness or numbness. Fallers also showed more frequent evidence suggestive of cognitive impairment. More fallers than non-fallers were taking diuretics and tranquilizers and these associations merit further study.
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PMID:Factors associated with falls in the elderly: a community study. 727 Mar 21

In a health survey of 2,032 elderly Hong Kong Chinese aged 70 years and over selected by stratified random sampling, a subset of 199 subjects (96 M, 103 F) were selected for a study of their lipid profile. No age and sex differences were observed in mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride concentrations in this subgroup. Compared with values from younger Chinese subjects from a previous survey, TC and LDL-C showed an age-related rise up till about 60 years, followed by a gradual decline. HDL-C concentrations showed little variation with age. Nonagenarians had a LDL/HDL ratio similar to subjects in the < 24 age group and lower than male subjects in the age 35-64 age group. HDL-C was lower in those with heart disease or hypertension. Other lipid parameters were not influenced by the presence of other chronic diseases, self-perceived health status, or cognitive impairment. TC was positively associated with the Barthel Index, a measure of functional ability. Positive associations between obesity indices and diastolic blood pressure, and TC, LDL-C, and triglycerides were present.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lipid profile in the Chinese old-old: comparison with younger age groups and relationship with some cardiovascular risk factors and presence of diseases. 811 74

The prevalence of cognitive impairment was determined in a random age- and sex-stratified sample of 2,011 elderly Hong Kong Chinese, aged 70 years and over, consisting of subjects living in the community and in institutions. The Information/Orientation Section of the Clifton Assessment Procedure was used as the screening instrument using a cutoff point of 7. The overall age-adjusted prevalence was 5% for men and 22% for women, and 15% for both sexes combined. Univariate analysis identified the following associated factors in order of magnitude of the odds ratio: age; history of Parkinson's disease; functional disability; female sex; low educational level; low social class; history of stroke, and low monthly income. Other diseases, such as heart disease, hypertension, chronic lung diseases or diabetes, were not associated factors. In multivariate analysis, all the above factors remained significant with the exception of a history of stroke. The prevalence figures are comparable to other Caucasian and Chinese studies, and the associated factors identified suggest that there may be room for prevention.
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PMID:Prevalence of cognitive impairment and associated factors among elderly Hong Kong Chinese aged 70 years and over. 819 Feb 6

Hypertension is a major risk factor for stroke and heart disease in elderly people. Eighty hypertensive subjects with mild cognitive impairment, aged over 70 years were drawn from a community screening programme and randomized to either captopril 12.5 mg twice daily or bendrofluazide 2.5 mg daily in a double-blind trial. Subjects were excluded if they had previously received antihypertensive treatment or had significant cardiac disease. Electrocardiograms (ECG) were recorded and scored at baseline and after 12 and 24 weeks of treatment. Mean blood pressure fell significantly and equally in both treatment groups. Most ECG variables remained unchanged throughout the trial but a significant reduction in QRS duration from 0.08 to 0.07 seconds was observed with captopril at 12 weeks (p = 0.004) and 24 weeks (p = 0.002). Subjects on captopril also exhibited a significant improvement in overall ECG classification at 12 weeks (p < 0.05), although this was not sustained at 24 weeks (p = 0.076). Captopril is a suitable alternative to bendrofluazide as an antihypertensive drug for elderly people with regard to ECG detected cardiac complications.
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PMID:Hypertensive Old People in Edinburgh (HOPE) Study: electrocardiographic changes after captopril or bendrofluazide treatment. 823 24

The potential long-term benefits of estrogen replacement therapy (ERT) in the prevention of osteoporosis and heart disease have been reasonably well established. However, the favorable effects of ERT on cognitive function and prevention of senile dementia in old age now represents a revitalized area of clinical research. A growing body of experimental evidence has recently provided the neurobiologic basis to support the hypothesis that gonadal hormones such as estrogen have psychologic effects on human brain function and behavior. Studies in women who have undergone surgical menopause have demonstrated that the menopause is associated with subclinical cognitive and affective dysfunction, which is improved by ERT. In addition, a growing body of evidence suggests that estrogen may be an effective therapy for senile dementia in some elderly women. Recent epidemiologic studies have indicated that long-term postmenopausal ERT may prevent late-life cognitive dysfunction in older women. Several clinical trials employing oral estrogen therapy have also observed that some aged women with senile dementia have improved cognitive and affective function after estrogen therapy. Estrogen loss resulting in cognitive disorders, including menopausal cognitive dysfunction and senile dementia in late life, may act via several mechanisms. Estrogen may be an important growth factor for estrogen-responsive neurons. Estrogen therapy may also have substantial neurochemical effects, direct effects on the vasculature, and effects on the generation of free radicals, which may be toxic to neurons. At this time, several important clinical questions need to be answered regarding the role of ERT in the cognitive and affective dysfunctions associated with menopause and senile dementia. Should estrogen be used for menopausal women whose sole complaint is cognitive or affective dysfunction? Does long-term ERT prevent cognitive decline in late life if initiated at the time of menopause? Can ERT improve cognition and affective function in postmenopausal women with Alzheimer's disease, and does estrogen therapy prevent the progression of Alzheimer's disease in these patients? Finally, do the vascular effects of estrogen play a role in the treatment or prevention of both Alzheimer's disease and vascular dementia?
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PMID:Future therapeutic developments of estrogen use. 853 Jul 15

In order to discover the prevalence of white matter low attenuation (WMLA) in the brain and its relationship to vascular risk factors in our Memory Disorders Clinic patients we assessed brain CT scans of 202 patients referred to our clinic between January 1991 and December 1992. One hundred patients (49.5%) had WMLA, and the prevalence increased with increasing severity of cognitive impairment. It was 12% in patients with no evidence of dementia, 32% in those with isolated memory loss, and 59%) in patients with possible or probable dementia. There was a correlation between WMLA and systolic blood pressure, heart disease, peripheral vascular disease, focal neurological signs on examination and central atrophy on CT. No correlation was found between WMLA and low blood pressure, blood glucose or cholesterol level. Our findings indicate that WMLA probably plays an important role in cognitive impairment, and that thromboembolic rather than haemodynamic factors are probably more important in its pathogenesis.
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PMID:The relationship between white matter low attenuation on brain CT and vascular risk factors: a memory clinic study. 866 45

Dehydroepiandrosterone (DHEA; prasterone) is a major adrenal hormone with no well accepted function. In both animals and humans, low DHEA levels occur with the development of a number of the problems of aging: immunosenesence, increased mortality, increased incidence of several cancers, loss of sleep, decreased feelings of well-being, osteoporosis and atherosclerosis. DHEA replacement in aged mice significantly normalised immunosenescence, suggesting that this hormone plays a key role in aging and immune regulation in mice. Similarly, osteoclasts and lymphoid cells were stimulated by DHEA replacement, an effect that may delay osteoporosis. Recent studies do not support the original suggestion that low serum DHEA levels are associated with Alzheimer's disease and other forms of cognitive dysfunction in the elderly. As DHEA modulates energy metabolism, low levels should affect lipogenesis and gluconeogenesis, increasing the risk of diabetes mellitus and heart disease. Most of the effects of DHEA replacement have been extrapolated from epidemiological or animal model studies, and need to be tested in human trials. Studies that have been conducted in humans show essentially no toxicity of DHEA treatment at dosages that restore serum levels, with evidence of normalisation in some aging physiological systems. Thus, DHEA deficiency may expedite the development of some diseases that are common in the elderly.
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PMID:Dehydroepiandrosterone and diseases of aging. 889 25

We investigated the association of non-insulin-dependent (Type 2) diabetes mellitus and depression symptoms in a representative community-dwelling elderly population independently of other conditions such as gender, age, status, disability, cognitive impairment and a number of chronic medical conditions such as chronic obstructive lung disease, degenerative joint disease, heart disease, cirrhosis of the liver, cholelithiasis, peptic ulcer and kidney stones. A total of 1339 elderly subjects living in southern Italy were randomly selected from electoral rolls and evaluated. All subjects were tested by the Geriatric Depression Scale to detect depression, the Mini-Mental State Examination to study cognitive function and the Activity Daily Living Index to evaluate disability. Non-insulin-dependent diabetes mellitus affected 14.7% of our sample. Depression was more prevalent in women over 75 years of age than in younger women (15.9 vs 8.1%, p < 0.001). In multiple linear regression analysis, diabetes mellitus was found to be significantly associated with depression independently of age, gender, loneliness, cognitive impairment, chronic obstructive lung disease, degenerative joint disease, heart diseases, cancer, kidney disease, cirrhosis of the liver and cholelithiasis. It is concluded that non-insulin-dependent diabetes mellitus is significantly associated with depression in the elderly, which may have clinical implications for the achievement of sufficient blood glucose control.
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PMID:Non-insulin-dependent diabetes mellitus is associated with a greater prevalence of depression in the elderly. The Osservatorio Geriatrico of Campania Region Group. 889 92


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