Demented Outpatients Research Articles

An investigation of dementia among elderly outpatients

A total of 110 unselected demented outpatients aged 60 and over (mean age: 76.2 years), 69 women and 41 men, were prospectively investigated. A potentially reversible cause of dementia was found in 26 patients (normal pressure hydrocephalus 2, cerebral tumor 1, hyperthyroidism 2, hypothyroidism 4, vitamin B12 deficiency 13, pseudodementia 4). Follow-up investigation showed that the only true reversible dementia in which improvement from abnormal to normal mental status occurred and was sustained for up to 2 years was 1 case of normal pressure hydrocephalus and 1 case of pseudodementia. In all cases of vitamin B12 deficiency, hypothyroidism and hyperthyroidism, despite proper treatment, mental status did not improve significantly and follow-up in most cases showed persistant cognitive deterioration. It can be concluded that although true reversible dementias do exist, they do not seem as prevalent as previously reported. Most elderly outpatients with reversible causes of dementia do not revert to normal and continue showing progressive decline.

Correlations of Mini-Mental State and modified Dementia Rating Scale to measures of transitional health status in dementia.

Information regarding the relationships of the Mini-Mental State (MMS) and a modified Dementia Rating Scale (mDRS) to measures of change, that is, "transitional" health status, in dementia would be potentially useful in the evaluation and care of demented patients. In a longitudinal study of demented outpatients, MMS and mDRS at entry and at 1- to 2-year follow-up were significantly correlated with five measures of physician- and advocate-rated transitional health status and change in living arrangement during this interval (p less than .01). MMS and mDRS at follow-up also predicted mortality during a subsequent year of follow-up (p less than .01). Estimated change in MMS and mDRS was significantly correlated with all transition variables, except for MMS and results suggest MMS, mDRS, and estimated change in them reflect these aspects of transitional health status in dementia.

Computerized data base for evaluation and follow-up of demented outpatients.

In the course of evaluating and following more than 600 geriatric outpatients referred to a subspecialty clinic because of cognitive impairment, standardized computer-compatible evaluation and follow-up forms were developed, as well as a computerized data base. The forms cover medical, neurologic, psychiatric, psychometric, and clinical laboratory examinations; they help health professionals to perform thorough, standardized, and efficient examinations focused on those characteristics relevant to dementias. The computerized data base facilitates follow-up and other clinical studies. This article presents both the forms and their translation into query-language terminology.

The dexamethasone suppression test in demented outpatients with and without depression

The dexamethasone suppression test (DST) was given to 33 elderly, male outpatients, previously diagnosed by DSM-III criteria as having dementia. Fifteen of these patients also had signs and symptoms of depression and, except for the presence of organic mental syndrome, would have met DSM-III criteria for major depressive episode. Of these 15 depressed, demented patients, 40% had abnormal DST results. None of the 18 patients who had dementia alone had abnormal DSTs. Our data suggest that in elderly, demented outpatients, an abnormal DST may be associated with concomitant depression.