Brain Atrophy in First-Episode Psychosis of the Elderly Is Associated With Cognitive Decline.

To study brain atrophy and cognitive decline in elderly patients with first-episode psychosis (FEP). Elderly patients aged ≥ 60 years with FEP and onset of psychotic symptoms of ≤ 1 year remitted to the Helsinki University Hospital from December 2009 to December 2011 were included in the study. Diagnoses were made using criteria.

Introducing a family intervention to elderly with first episode psychosis.

Schizophrenia guidelines list family interventions as an efficient means in reducing relapses. Interventions aim to help families cope with their relative's problems more effectively, provide support and education, and reduce levels of distress and improve the family communication (see deHaan et al., 2002).

Brain atrophy is a frequent finding in elderly patients with first episode psychosis.

Background: To characterize the yearly incidence, diagnostic distribution, and neuro-radiologic findings in patients aged over 60 years, referred to psychiatric treatment with first episode psychosis (FEP).

Methods: A computerized search, including all patients referred to psychiatric treatment during 12 consecutive months with a de novo diagnosis of psychosis was performed in the Helsinki region catchment area with 1.2 million inhabitants.

Of Sound Mind? Dementia and Aspects of Assessing Legal Capacity.

As dementia progresses, it weakens a person's legal capacity. Both legal and medical aspects are closely intertwined in the assessment of legal capacity. It is a legal problem whose solution requires medical expertise and a medical point of view.

[Incipient cognitive disorder--when does concern of memory impairment direct to comprehensive examinations?].

Early recognition of middle-aged and elderly peoples cognitive disorders requires alertness from physicians. Examinations are needed when concern of memory impairment is presented: an incipient memory disorder should be considered in cases of depression, functional impairment, unsuccessful rehabilitation or delusional disorder. The diagnostics of cognitive disorders in Finland is mainly excellent.

[Assessment of legal functional capacity of a neuropsychiatric patient].

Legal functional capacity refers to the ability to make decisions having financial and legal competence. In neuropsychiatric disorders a somatic or developmental brain damage causes psychological, behavioral and cognitive symptoms that lessen the capacity required for legal competence. Such disease groups include memory disorders, brain injuries and disturbances of the cerebral circulation as well as severe mental disorders causing prolonged psychotic symptoms.

Comparison between clinical diagnosis and CSF biomarkers of Alzheimer disease in elderly patients with late onset psychosis: Helsinki Old Age Psychosis Study (HOPS).

Objectives: To determine the proportion of elderly people with a first psychotic episode actually suffering from dementia, especially Alzheimer disease (AD), by using cerebrospinal fluid (CSF) biomarkers.

Design: Prospective case-control study.

Setting And Participants: Sixty-six patients age 65 years and older with recent psychotic symptoms and 12 comparison subjects with chronic schizophrenia over 10 years that were referred to acute old age psychiatry, in-ward treatment.

[The treatment pathway of a memory disorder patient].

The treatment of a memory disorder patient is multiprofessional teamwork requiring professional personnel specialized in memory disorders. The memory disorder clinic plays a central role especially at the diagnostic stage. Treatment should be carried out as local services and according to the needs of the patients.

[Early detection of cognitive changes in memory diseases: new cut-off scores for the Finnish version of CERAD neuropsychological battery].

The evaluation of cognitive functions by using CERAD (Consortium to Establish a Registry for Alzheimer's Disease) is recommended as a tool in basic health care for screening of memory diseases. The reliability of this method, adopted in Finland in 1999, has been impaired by the fact that there have been no comprehensive Finnish norms to serve as the basis for the cut-off limits of the test tasks. This article presents the new, revised cut-off values for the CERAD procedure, based on the comparison of Finnish population-based normative data with those of persons having very mild or mild Alzheimer's disease.

Neuropathologic findings of dementia with lewy bodies (DLB) in a population-based Vantaa 85+ study.

The consortium on dementia with Lewy bodies has established consensus guidelines for the neuropathologic diagnosis of dementia with Lewy bodies (DLB) including the likelihood that the neuropathologic findings associate with the clinical syndrome. Nevertheless, clinico-pathological correlations remain controversial. We applied the consensus guidelines for determining Lewy-related pathology (LRP) and evaluated the clinical presentation in the prospective, population-based Vantaa 85+ study consisting of individuals at least 85 years of age.

Vascular risk factors and dementia in the general population aged >85 years: prospective population-based study.

The aim of this study was to evaluate the association between dementia and common vascular risk factors including blood pressure, blood lipids, homocysteine and diabetes mellitus in a population of very old people. This study is a 9-year follow-up prospective population-based study monitoring 339 non-demented subjects aged 85 years or over in the city of Vantaa, Southern Finland. During the follow-up, those individuals with diabetes mellitus at the baseline and new incident stroke had a higher probability for developing dementia.

Double-blind, randomized comparison of memantine and escitalopram for the treatment of major depressive disorder comorbid with alcohol dependence.

Objective: The aim of the study was to evaluate possible new treatments for major depressive disorder in patients with comorbid alcohol dependence in a municipal alcohol treatment unit. The efficacy of memantine, a noncompetitive glutamate N-methyl-D-aspartate (NMDA)-receptor blocker used for the treatment of moderate to severe Alzheimer's disease, was compared with that of escitalopram, a selective serotonin reuptake inhibitor antidepressant.

Method: Eighty alcohol-dependent outpatients with major depressive disorder (DSM-IV criteria) seeking treatment from municipal alcohol treatment clinics in Helsinki, Finland, were randomly assigned 1:1 to receive memantine 20 mg/day or escitalopram 20 mg/day.

Atrial fibrillation, stroke, and cognition: a longitudinal population-based study of people aged 85 and older.

Background And Purpose: The aim of this study was to investigate the association between atrial fibrillation (AF), stroke, dementia, and their correlation with brain pathology in subjects aged 85 years or older.

Methods: This is a prospective 9-year follow-up population based study in Vantaa, a town in Southern Finland; 553 subjects (92% of the total population) aged 85 years or older were clinically examined by a neurologist. The presence of AF was collected from the medical records or examined by ECG or ambulatory ECG.

Association between blood pressure and survival over 9 years in a general population aged 85 and older.

Objectives: To investigate the association between blood pressure and mortality in people aged 85 and older.

Design: Population-based prospective study with 9-year follow-up.

Setting: Department of Neuroscience and Neurology and Department of Public Health and General Practice, University of Kuopio, and Department of Clinical Neurosciences, Helsinki University Hospital.

Incidence of dementia in very elderly individuals: a clinical, neuropathological and molecular genetic study.

Aims: To evaluate the effect of medical record use on figures for the incidence of dementia and the effect of apolipoprotein E (APOE) polymorphism on this incidence and neuropathologically defined Alzheimer's disease (AD) in very elderly individuals.

Methods: Cognitive functions were examined in a cohort of 328 (92% of the very elderly people of a town participated in this study) nondemented Finnish elderly individuals 85 years of age or more in 1991. The examination was repeated in survivors in 1994, 1996, 1999 and 2001.

Association of apolipoprotein E genotypes, blood pressure, blood lipids and ECG abnormalities in a general population aged 85+.

Background: Several studies have linked apolipoprotein E (ApoE) epsilon4 allele with elevated cholesterol and blood pressure levels. Data on the association of APOE genotypes with blood pressure, lipids, atrial fibrillation and ECG abnormalities in individuals aged 85 years and over is sparse.

Methods: This cross sectional study consisted of all residents of the city of Vantaa (N = 601) aged 85 years or over of whom 505 participated in the study.