Hyponatraemia and selective serotonin re-uptake inhibitors in elderly patients.

Hyponatraemia (serum sodium arbitrarily defined as less than 135 mmol/L) is an increasingly recognised adverse effect of selective serotonin re-uptake inhibitors (SSRIs). Its precise prevalence and incidence in the elderly are hard to determine because of confounding factors including other prescribed medications and medical conditions. Although hyponatraemia has been reported with all SSRIs and venlafaxine, most studies are small, retrospective, limited by confounding variables or are individual case reports.

Equity of access to a memory clinic in Melbourne? Non-English speaking background attenders are more severely demented and have increased rates of psychiatric disorders.

Objectives: The aim of this study was to compare demographic and clinical features of patients from Non-English Speaking Background (NESB) with those from English Speaking Background (ESB) who attended a memory clinic in Melbourne, Australia.

Methods: Data on 556 consecutive patients attending the memory clinic were analysed retrospectively. All patients were assessed by a geriatrician (Italian speaking) or psychogeriatrician with the aid of Cambridge Examination for Mental Disorders in the Elderly (CAMDEX) interview schedule.

Characteristics of aggressive subjects in Australian (Melbourne) nursing homes.

Background: Aggressive behavior is common in nursing homes for the elderly. It causes distress to carers and can lead to hospitalization, overmedication, and physical restraint.

Method: A 6-month prospective study examining the characteristics of aggressive subjects in 11 nursing homes in Melbourne using validated, reliable instruments.

Effects of the nicotinic antagonist mecamylamine on inspection time.

Rationale: Several lines of evidence suggest that nicotinic acetylcholine receptors (nAchRs) are involved in speed of information processing, and inspection time appears to be particularly sensitive to nicotinic manipulation.

Objective: The present study sought to examine the effects of the nAchR antagonist mecamylamine on inspection time. Furthermore, the extent to which the anticholinesterase donepezil would reverse the effects of mecamylamine on inspection time was also examined.

Novel Leu723Pro amyloid precursor protein mutation increases amyloid beta42(43) peptide levels and induces apoptosis.

A novel missense mutation, Leu723Pro, in the amyloid precursor protein (APP) gene was discovered in an early-onset Alzheimer's disease family. Expression of L723P mutant APP complementary DNA in CHO cells resulted in a 1.4- to 1.

Do memory clinics improve the quality of life of carers? A randomized pilot trial.

Objective: To determine the effects of attendance at a memory clinic on the psychosocial health of carers.

Design: Randomized control trial.

Participants: Fifty community dwelling subjects with mild to moderate dementia and their carers.

The Even Briefer Assessment Scale for Depression (EBAS DEP): its suitability for the elderly in geriatric care in English- and German-speaking countries.

Objectives: To determine the psychometric properties of the Even Briefer Assessment Scale for Depression (EBAS DEP) developed by Allen et al. (1994) among samples of the German elderly and compare the results with those from English-speaking countries.

Design: Depression scale scores from elderly persons in residential and gerontopsychiatric care were assessed for internal consistency using Cronbach's alpha and validity (Feighner Criteria of Depression and Center for Epidemiologic Studies Depression Scale).

Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study.

Objective: To determine the difference in outcome among elderly people with major depression who do and do not have severe white matter lesions on magnetic resonance imaging.

Design: Follow up study.

Setting: Two psychiatric and two general hospitals in Melbourne, Australia.

The psychosocial health status of carers of persons with dementia: a comparison with the chronically ill.

This project aimed to determine overall psychosocial health (measured using the psychosocial dimension of the Functional Limitations Profile) and factors which influence this in a group of carers of those with dementia and to compare their psychosocial health with that of older people attending general practitioners (GPs); arthritis support groups and a pain clinic (out-patients) and a group of community dwellers undergoing renal dialysis. The carer group showed a significant decrease in recreation and pastimes and social interactions compared to older GP attenders. The carers showed similar restrictions in social interactions and recreation to those with chronic arthritis, but the latter were more impaired in the domains of emotional behaviour and sleep and rest.

Does hippocampal atrophy on MRI predict cognitive decline? A prospective follow-up study.

Objectives: To investigate whether the presence of hippocampal atrophy (HCA) on MRI in Alzheimer's disease (AD) leads to a more rapid decline in cognitive function. To investigate whether cognitively unimpaired controls and depressed subjects with HCA are at higher risk than those without HCA of developing dementia.

Design: A prospective follow-up of subjects from a previously reported MRI study.

Temporal lobe magnetic resonance imaging can differentiate Alzheimer's disease from normal ageing, depression, vascular dementia and other causes of cognitive impairment.

Background: Previous work suggests that temporal lobe magnetic resonance imaging (MRI) can distinguish those with dementia of the Alzheimer type (DAT) from healthy age-matched controls. However, its specificity with regard to conditions such as vascular dementia, depression and other disorders associated with cognitive impairment has not been determined.

Methods: We studied 222 subjects using T1 weighted MRI with 5.

Health care costs of people referred to an aged care assessment team: the effect of cognitive impairment.

The aim of this study was to determine the effect cognitive impairment has on direct and indirect costs to elderly people, their carers and the community over one year, by following prospectively a cohort of elderly people referred to an aged care assessment team. The 78 subjects were drawn from a random sample of people referred to the NorthWest Hospital team, and validated tools were used to assess their cognitive state. Outcome measures included total costs of community services, residential care, hospital bed use, carer burden and psychological morbidity.

The relationship between two scales measuring aggressive behaviour among elderly nursing home residents.

Data from a large 6-month prospective study of aggressive behaviour in 11 nursing homes for the elderly are used to examine the relationship between two aggression scales (SOAS and RAGE). There was a strong and significant correlation between the SOAS and RAGE scales for the total and the subscale scores. Both these scales appear useful in measuring aggressive behaviour in nursing homes for the elderly and the nursing home staff can be trained in completing them effectively.

Plasma level monitoring of olanzapine in patients with schizophrenia: determination by high-performance liquid chromatography with electrochemical detection.

A sensitive high-performance liquid chromatography method with electrochemical detection for the determination of olanzapine in human plasma is described. Olanzapine from plasma samples was isolated by a simple one-step liquid--liquid extraction with 15% methylene chloride in pentane with an extraction recovery of approximately 94% of the total olanzapine in plasma. The compound was separated on a cyano column.

Does risperidone improve verbal working memory in treatment-resistant schizophrenia?

Objective: Treatment efficacy in schizophrenia is typically defined in terms of symptom reduction. However, new antipsychotic medications could potentially have an impact on aspects of disability, such as neurocognitive deficits. The authors evaluated the effects of risperidone on verbal working memory, a memory component of theoretical interest because of its link to prefrontal activity and of practical interest because of its link to psychosocial rehabilitation.

Magnetic resonance imaging correlates of memory impairment in the healthy elderly: association with medial temporal lobe atrophy but not white matter lesions.

Objective: To investigate the neuroradiological correlates of age-related cognitive decline in the elderly.

Design: A sample of healthy control subjects underwent magnetic resonance imaging (MRI) scanning and cognitive testing.

Setting: Melbourne, Australia.

Clinical, magnetic resonance imaging and endocrinological differences between delusional and non-delusional depression in the elderly.

Objective: To investigate neuroradiological, endocrinological and clinical differences between delusional and non-delusional depression.

Design: A cross-sectional study of depressed subjects.

Setting: Melbourne, Australia.

The predictive value of dementia screening instruments in clinical populations.

Objective: To determine the positive predictive value of the Mini-Mental Status Examination (MMSE), the Abbreviated Mental Test (AMT) and the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE) for dementia in different clinical settings.

Design: Sensitivity and specificity of tests were compared against the criterion standard of clinical diagnosis made by a geriatrician or psychogeriatrician.

Setting: Two groups of patients were studied, a referred group of outpatients to a memory clinic (MC) and a random selection of patients referred to an aged care assessment team (ACAT).

The relationship between sociotropy/autonomy and patterns of symptomatology in the depressed elderly.

This study examined the relationship between the personality constructs of sociotropy and autonomy and clinical symptoms of depression among 80 elderly people reporting to a range of psychiatric services for the treatment of depression. These investigations provided support for the association of sociotropy to a hypothesized pattern of clinical symptomatology, but no support for the relationship of autonomy to its hypothesized pattern of symptoms. Future investigations on elderly depressive people needs to accommodate the clinical patterns more typical of this population.