Dementia

The psychiatric community has a need for diagnostic and predictive tests. Some recent techniques have just become available for clinical care.

The Risk of Cerebrovascular Problems in Patients With Dementia Treated With Atypical Antipsychotics

mental notes

A review of nonconvention treatments for dementia and mild cognitive impairment, including dietary modification, Ginkgo Biloba, Huperzine-A, Phosphatidylserine, CDP-choline, Idebenone, and exercise.

Patients with Alzheimer disease (AD) often have Lewy body pathology (LBP). Although the exact significance of LBP is unknown, LBP appears to be more common in persons with familial AD related to gene mutations of presenilin 1 (PSEN1), presenilin 2 (PSEN2), and amyloid precursor protein. To examine the genetics of LBP, the team from Puget Sound HCS, led by James B. Leverenz, MD, associate professor at the University of Washington in Seattle, reviewed 25 familial AD cases that included 9 known PSEN1 mutations and 14 familial AD cases that included a single PSEN2 mutation. The brain stem, limbic cortex, and neocortex were examined for LBP.

Physicians who use electroconvulsivetherapy (ECT) need tobe vigilant for unstable medicalconditions before and during the courseof treatment. This brief review is intendedto highlight some basic principlesand specific concerns that maybe encountered in the use of ECT inpatients who have comorbid medicalillness.

During and after menopause, many women report impairments in cognitive functioning. Should hormones be prescribed in an effort to mitigate cognitive symptoms of menopause?

The cost-effectiveness of treatment for Alzheimer disease has been questioned. But until the next generation of therapeutics arrives, cholinesterase inhibitors and memantine will probably remain essential components of therapy for cognition and function.

Dementia is characterized as a progressive and chronic decline in cognitive function, not limited to memory impairment, which significantly interferes with baseline daily functioning and frequently involves behavioral disturbances. It is known that behavioral problems in dementia negatively affect patients and caregivers. These disturbances lead to institutionalization, increased costs and caregiver burden, and a poorer prognosis.

Obesity has long been recognized as increasing the risk of associated conditions, including hypertension, diabetes, and cardiovascular disease. Now another disorder has been added to this chilling list: Alzheimer disease (AD).

Alzheimer disease, cognitive impairment, neurologic imaging

Patients with Alzheimer's disease may suffer the same age- and disease-related changes to sleep as their age-matched peers. However, as the dementia progresses, even more severe disturbances develop, with impairments in both nighttime sleep continuity and daytime alertness. This article focuses on long-term, holistic approaches to treatment, including environmental and behavioral interventions to augment sleep medications.

Affecting 70% of patients with Alzheimer's disease and common in patients suffering from other dementing illnesses, apathy is associated with functional impairment and caregiver distress at all levels of disease severity. Assessment and treatment for this under-recognized syndrome are discussed.

Advances in technology are providing assistive and supportive interventions for people with dementia across all aspects of their lives. These interventions are mainly addressed at meeting the safety, security and social needs of people with dementia. The psychological needs of people with dementia for conversation and other forms of positive social interactions are also being tackled through developments such as the CIRCA project.

Patients with HIV infection are at risk of developing psychiatric symptoms and disorders similar to those seen in the general population. What unique biological, psychological and environmental factors are involved in treating this population?

stroke, tissue plasminogen activator, tPA, stent, transcranial Doppler, MRI

Alzheimer disease (AD) affects between 6% and 8% of Americans older than 65 years. As the population of older adults increases, the number of persons with AD is expected to rise from 4.5 million in 2000 to 13.2 million by 2050.1 This disease is important not only because of the number of patients affected but also because it leads to significant physical and emotional burdens on families and caregivers.

"Pseudodementia" needs a third look. Always a "soft" diagnosis, it has never had objective, explicit diagnostic criteria or a spot in an official nomenclature.

More than 100 neurologic diseases, injuries, and intoxications are known to prominently or exclusively involve the white matter of the brain.

Published research is now backing up what would appear to many to be a clear heart and brain connection. As more of this research is circulated, it could have a direct impact on how neurologists practice medicine and on how neurologists and primary care physicians treat patients and interact with each other.

The post-stroke patient is at significant risk for various psychiatric syndromes. The most commonly reported of these in the literature are post-stroke depression (PSD) and post-stroke dementia (PSDem), which may present simultaneously with overlapping mood and cognitive symptoms. In this article, we offer a review of current literature on post-stroke psychiatric syndromes and an integrated clinical approach to screening, diagnosis, and pharmacologic intervention.

The prevalence of major depression following stroke ranges from 10% to 40%. Other psychiatric disorders, including anxiety disorders, apathy and cognitive impairment are also common. Psychiatrists need to be on the lookout for symptoms not just immediately poststroke, but up to six months after the event.

In the second part of this series, read about the special issues psychiatrists face when treating women, children and adolescents, and elderly people with bipolar disorder and dementia. What are the recommendations for care and monitoring strategies to maintain patients on effective, long-term treatment regimens?

It has been well established that there is a high incidence of depression in conjunction with Alzheimer's disease and other forms of dementia. What are the best assessment and diagnostic methods, and which treatments will produce the best results?

Depression and dementia or Alzheimer's disease often go together. The presence of dementia may also increase the odds of depression. What can clinicians do to treat these two often comorbid conditions?

New developments in neuroimaging and effective diagnostic tools can help obtain early diagnosis of and timely treatment for Alzheimer's disease.

The promise of natural products as possible sources of new treatments for Alzheimer's disease and other dementing illnesses is on the rise. Scientific evidence for the 13 dietary supplements most commonly used for memory impairment is analyzed and evaluated.

Alzheimer's disease (AD) is a devastating and debilitating neurodegenerative condition, and the most common cause of dementia among the elderly. Despite considerable advances in the cellular and molecular biology of AD, however, little progress has been made in identifying the causes of the disease.

The obvious sometimes bears repeating: Sick people have trouble thinking. They may be suffering from a delirium, a dementia or a more subtle disturbance of cognition caused by fever, drugs, infection, inflammation, trauma, hypoxemia, metabolic derangement, hypotension, tumor, intracranial pathology, pain and so forth.

Atypical antipsychotic treatment for borderline personality disorder (BPD) and augmentation therapy with olanzapine (Zyprexa) or estrogen replacement therapy (ERT) for patients with mood disorders were among the research questions addressed at the American Psychiatric Association's annual meeting in Toronto. Following are some brief reports of selected presentations.