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Reinhard Heun - One of the best experts on this subject based on the ideXlab platform.

  • The factor structure in the cognitive battery of the structured interview for the diagnosis of Dementia of the Alzheimer type, multi-infarct Dementia, and Dementias of other aetiology.
    International psychogeriatrics, 2001
    Co-Authors: Martin Kockler, Reinhard Heun
    Abstract:

    The Structured Interview for the Diagnosis of Dementia of the Alzheimer Type, Multiinfarct Dementia, and Dementias of Other Aetiology (SIDAM) includes the Mini-Mental State Examination extended by a number of additional items and allows the diagnosis of Dementia according to ICD-10 and DSM-III-R criteria. The authors proposed to summarize selected items to form syndrome scores. These syndrome scores are supposed to measure different aspects of cognition. However, these syndrome scores have not been empirically confirmed. The present article presents a principal component analysis performed on the SIDAM test performances of 456 elderly subjects. The subjects were recruited in the course of a family study on Dementia of the Alzheimer's type and depression in the elderly. One hundred four of these subjects met the criteria of Dementia according to the ICD-10 criteria. Thus, the sample represents the population in which the SIDAM is frequently used in routine clinical and epidemiological studies. We found a six-factor structure accounting for 57.1% of the variance with some similarities to the predefined structure of different syndrome scores proposed by the authors of the SIDAM. The first factor found in principal component analysis represented different higher cortical functions that all depend on language and comprehension. Three factors covered three different aspects of memory, i.e., orientation for time, orientation for place, and short-term memory. One factor represented visuoconstructive skills and, finally, there was a factor representing intellectual abilities and education. This empirically found factor structure characterizes the dimensions of cognitive deficits in demented subjects measured by the SIDAM. Syndrome scores should reflect these dimensions. Consequently, we propose to consider the empirically found factor structure in a new version of the SIDAM.

  • Detection of subthreshold depression and subthreshold anxiety in the elderly.
    International journal of geriatric psychiatry, 1999
    Co-Authors: Andreas Papassotiropoulos, Reinhard Heun
    Abstract:

    OBJECTIVE: To assess the ability of screening instruments to detect subthreshold depression or subthreshold anxiety and to make suggestions for the improvement of instrument performance. DESIGN: Group definition relied on the presence or absence of major psychiatric disorders or of subthreshold disorders (Composite International Diagnostic Interview). SETTING: A community-based study in Germany. PARTICIPANTS: The total sample comprised 274 subjects over 60 years of age; 57 subjects suffered from acute subthreshold depression, 26 subjects suffered from acute subthreshold anxiety, 173 subjects were defined as being healthy (i.e. no acute or lifetime major psychiatric disorder, no acute subthreshold disorder). MEASURES: The short version of the General Health Questionnaire (GHQ-12), the Center for Epidemiologic Studies--Depression Scale (CES-D), the Structured Interview for the Diagnosis of Dementia of the Alzheimer-type, Multiinfarct Dementia and Dementias of other Etiology (SIDAM) for cognitive impairment. RESULTS: Subjects with subthreshold disorders scored higher on the CES-D and the GHQ-12 than healthy individuals. The most distinct increase was observed in the CES-D score of subjects with subthreshold anxiety. The CES-D factor for the presence of somatic/vegetative symptoms performed slightly better compared to the other CES-D factors. CONCLUSIONS: The CES-D moderately detected subthreshold anxiety. Subthreshold depression could not be efficiently detected by either questionnaire. The combination of items indicating the presence of somatic symptoms and depressive affect could improve instrument performance when screening for subthreshold anxiety but not for subthreshold depression.

  • DEMENZSCREENING IM KLINISCHEN ALLTAG: EINE VERGLEICHENDE ANALYSE VON MMSE,SIDAM UND ADAS
    Der Nervenarzt, 1998
    Co-Authors: Martin Burkart, Reinhard Heun, Wolfgang Maier, Otto Benkert
    Abstract:

    Dementia-screening in clinical routine requires short, sensitive and specific tools. A number of standardized instruments are available for this purpose. The present study analysed the relationship between size of three exemplary Dementia-screening tests and their diagnostic accuracy. The Mini-Mental-State-Examination (MMSE), the Structured Interview for the Diagnosis of Dementia of the Alzheimer-type, Multiinfarct Dementia and Dementias of other Aetiologies according to ICD-10 and DSM-III-R (SIDAM) and the Alzheimer's Disease Assessment Scale (ADAS) were applied to 71 patients with Dementia of the Alzheimer-type and 73 non-demented controls. A ROC-analysis revealed that neither SIDAM nor ADAS differentiated better between demented and non-demented probands than the MMSE. This was also true for patients with mild Dementia. In Dementia staging the more comprehensive instruments did not surpass the MMSE, too. Due to it's brevity, the MMSE is the preferential screening-instrument for clinical routine.

Stephen Greenberg - One of the best experts on this subject based on the ideXlab platform.

  • Twenty-four—hour ambulatory electrocardiography in elderly subjects: Prevalence of various arrhythmias and prognostic implications (report from the Bronx Longitudinal Aging Study)
    American Heart Journal, 1996
    Co-Authors: William H. Frishman, Mark Heiman, Alexander Karpenos, Wee Lock Ooi, Anne Mitzner, Ronen Goldkorn, Stephen Greenberg
    Abstract:

    Abstract Functional, ambulatory, community-dwelling subjects ( n = 423, aged 75 to 85 years) underwent baseline 24-hour ambulatory electrocardiography (ECG) examinations as part of the Bronx Aging Study, a 10-year prospective cohort study designed to identify risk factors and disease markers for cardiovascular, cerebrovascular, and Dementia illnesses in old people. Premature ventricular contractions were the most commonly observed arrhythmia noted (93% of subjects), with a low prevalence of nonsustained ventricular tachycardia (5%), paroxysmal atrial tachycardia (13%), atrial fibrillation (4%), and atrioventricular blocks (4%). A 24-hour sinus rate of p = 0.015; relative risk [RR] 2.8; 95% confidence interval [CI] 1.4 to 5.8) and myocardial infarction ( p = 0.031; RR 3.2; CI 1.2 to 9.4). Transient atrioventricular block was an independent predictor of stroke ( p = 0.0006; RR 9.7; CI 3.3 to 28.9), as was sinus bradycardia over a 24-hour period ( p = 0.033; RR 2.7; CI 1.2 to 6.4). Ventricular tachycardia approached significance as an independent predictor of Multiinfarct Dementia ( p = 0.052; RR 6.3; CI 1.4 to 28.7). Episodes of paroxysmal atrial fibrillation, atrial tachycardia, and severe bradycardia were not associated with adverse outcomes. Some arrhythmias found on the ambulatory ECG in very old subjects can predict an increased risk for subsequent death, myocardial infarction, stroke, and Multiinfarct Dementia.

  • Twenty-four-hour ambulatory electrocardiography in elderly subjects: prevalence of various arrhythmias and prognostic implications (report from the Bronx Longitudinal Aging Study).
    American heart journal, 1996
    Co-Authors: William H. Frishman, Mark Heiman, Alexander Karpenos, Wee Lock Ooi, Anne Mitzner, Ronen Goldkorn, Stephen Greenberg
    Abstract:

    Functional, ambulatory, community-dwelling subjects (n = 423, aged 75 to 85 years) underwent baseline 24-hour ambulatory electrocardiography (ECG) examinations as part of the Bronx Aging Study, a 10-year prospective cohort study designed to identify risk factors and disease markers for cardiovascular, cerebrovascular, and Dementia illnesses in old people. Premature ventricular contractions were the most commonly observed arrhythmia noted (93% of subjects), with a low prevalence of nonsustained ventricular tachycardia (5%), paroxysmal atrial tachycardia (13%), atrial fibrillation (4%), and atrioventricular blocks (4%). A 24-hour sinus rate of < 60 beats/min was noted in 13% of subjects, and 11% of subjects were noted to have transient episodes of severe bradycardia (< 40 beats/min). In a multivariate analysis, nonsustained ventricular tachycardia was an independent predictor of death (p = 0.015; relative risk [RR] 2.8; 95% confidence interval [CI] 1.4 to 5.8) and myocardial infarction (p = 0.031; RR 3.2; CI 1.2 to 9.4). Transient atrioventricular block was an independent predictor of stroke (p - 0.0006; RR 9.7; CI 3.3 to 28.9), as was sinus bradycardia over a 24-hour period (p = 0.033; RR 2.7; CI 1.2 to 6.4). Ventricular tachycardia approached significance as an independent predictor of Multiinfarct Dementia (p = 0.052; RR 6.3; CI 1.4 to 28.7). Episodes of paroxysmal atrial fibrillation, a trial tachycardia, and severe bradycardia were not associated with adverse outcomes. Some arrhythmias found on the ambulatory ECG in very old subjects can predict an increased risk for subsequent death, myocardial infarction, stroke, and Multiinfarct Dementia.

Francisco J. Rubia - One of the best experts on this subject based on the ideXlab platform.

  • Topographic maps of brain electrical activity in primary degenerative Dementia of the Alzheimer type and Multiinfarct Dementia.
    Biological psychiatry, 1991
    Co-Authors: Manuel Martín-loeches, Pedro Gil, Fernando Jimenez, Francisco Javier Exposito, Francisco Miguel, Ramón Cacabelos, Francisco J. Rubia
    Abstract:

    The topography of the electroencephalographic (EEG) pattern of ten patients with primary degenerative Dementia of the Alzheimer type, ten Multiinfarct Dementia patients, and ten age-matched controls was compared during three different behavioral conditions: resting condition with eyes open (EO), memorizing a list of words (M), and recalling the same list of words (R). Results indicate that the alpha frequency band does not show significant changes. On the other hand, the theta band could be considered an important factor in the differential diagnosis of the primary degenerative Dementia of the Alzheimer type, showing a higher power over right posterior regions in this group of patients compared with the Multiinfarct Dementia patients under different behavioral conditions.

William H. Frishman - One of the best experts on this subject based on the ideXlab platform.

  • Twenty-four—hour ambulatory electrocardiography in elderly subjects: Prevalence of various arrhythmias and prognostic implications (report from the Bronx Longitudinal Aging Study)
    American Heart Journal, 1996
    Co-Authors: William H. Frishman, Mark Heiman, Alexander Karpenos, Wee Lock Ooi, Anne Mitzner, Ronen Goldkorn, Stephen Greenberg
    Abstract:

    Abstract Functional, ambulatory, community-dwelling subjects ( n = 423, aged 75 to 85 years) underwent baseline 24-hour ambulatory electrocardiography (ECG) examinations as part of the Bronx Aging Study, a 10-year prospective cohort study designed to identify risk factors and disease markers for cardiovascular, cerebrovascular, and Dementia illnesses in old people. Premature ventricular contractions were the most commonly observed arrhythmia noted (93% of subjects), with a low prevalence of nonsustained ventricular tachycardia (5%), paroxysmal atrial tachycardia (13%), atrial fibrillation (4%), and atrioventricular blocks (4%). A 24-hour sinus rate of p = 0.015; relative risk [RR] 2.8; 95% confidence interval [CI] 1.4 to 5.8) and myocardial infarction ( p = 0.031; RR 3.2; CI 1.2 to 9.4). Transient atrioventricular block was an independent predictor of stroke ( p = 0.0006; RR 9.7; CI 3.3 to 28.9), as was sinus bradycardia over a 24-hour period ( p = 0.033; RR 2.7; CI 1.2 to 6.4). Ventricular tachycardia approached significance as an independent predictor of Multiinfarct Dementia ( p = 0.052; RR 6.3; CI 1.4 to 28.7). Episodes of paroxysmal atrial fibrillation, atrial tachycardia, and severe bradycardia were not associated with adverse outcomes. Some arrhythmias found on the ambulatory ECG in very old subjects can predict an increased risk for subsequent death, myocardial infarction, stroke, and Multiinfarct Dementia.

  • Twenty-four-hour ambulatory electrocardiography in elderly subjects: prevalence of various arrhythmias and prognostic implications (report from the Bronx Longitudinal Aging Study).
    American heart journal, 1996
    Co-Authors: William H. Frishman, Mark Heiman, Alexander Karpenos, Wee Lock Ooi, Anne Mitzner, Ronen Goldkorn, Stephen Greenberg
    Abstract:

    Functional, ambulatory, community-dwelling subjects (n = 423, aged 75 to 85 years) underwent baseline 24-hour ambulatory electrocardiography (ECG) examinations as part of the Bronx Aging Study, a 10-year prospective cohort study designed to identify risk factors and disease markers for cardiovascular, cerebrovascular, and Dementia illnesses in old people. Premature ventricular contractions were the most commonly observed arrhythmia noted (93% of subjects), with a low prevalence of nonsustained ventricular tachycardia (5%), paroxysmal atrial tachycardia (13%), atrial fibrillation (4%), and atrioventricular blocks (4%). A 24-hour sinus rate of < 60 beats/min was noted in 13% of subjects, and 11% of subjects were noted to have transient episodes of severe bradycardia (< 40 beats/min). In a multivariate analysis, nonsustained ventricular tachycardia was an independent predictor of death (p = 0.015; relative risk [RR] 2.8; 95% confidence interval [CI] 1.4 to 5.8) and myocardial infarction (p = 0.031; RR 3.2; CI 1.2 to 9.4). Transient atrioventricular block was an independent predictor of stroke (p - 0.0006; RR 9.7; CI 3.3 to 28.9), as was sinus bradycardia over a 24-hour period (p = 0.033; RR 2.7; CI 1.2 to 6.4). Ventricular tachycardia approached significance as an independent predictor of Multiinfarct Dementia (p = 0.052; RR 6.3; CI 1.4 to 28.7). Episodes of paroxysmal atrial fibrillation, a trial tachycardia, and severe bradycardia were not associated with adverse outcomes. Some arrhythmias found on the ambulatory ECG in very old subjects can predict an increased risk for subsequent death, myocardial infarction, stroke, and Multiinfarct Dementia.

Walter Hewer - One of the best experts on this subject based on the ideXlab platform.

  • Multiinfarct Dementia vs Alzheimer's disease: sonographic criteria.
    Angiology, 1995
    Co-Authors: Stefan Biedert, Hans Förstl, Walter Hewer
    Abstract:

    Primary degenerative Dementia of the Alzheimer type (DAT) and Multiinfarct Dementia (MID) exhibit differences in cerebrovascular blood flow velocity profiles, which were investigated by means of transcranial Doppler sonography The pulsatility indices, as angle-independent parameters of peripheral vascular resistance, measured in middle cerebral and basilar arteries of patients with MID, were significantly increased (P < 0.005) with respect to cases of primary DAT and to healthy age-matched controls. Approximately 75% of all MID patients exhibited small-vessel disease rather than throm boembolism from the extracranial arteries and the heart, as judged by extracranial and transcranial Doppler sonographies, computerized cerebral tomographies, EEGs, and, if necessary, 2-D echocardiographies.