Neurology
Annals of Long-Term Care on the Web is a comprehensive resource for clinical information on geriatric medicine and long-term care as well as Neurology. We hope the articles below provide timely information for your practice.
June 2005 Cholinesterase Inhibitors Across Stages of Dementia and Cognitive Impairments in the Elderly
Salloway et al12 conducted a randomized, double-blind, placebo-controlled study of donepezil in 270 patients with MCI. A randomized, double-blind, placebo-controlled, 24-month study of galantamine in 1062 patients with MCI aimed to improve cognition and global functioning at 12 months, and to delay conversion to dementia.14 ADAS-Cog/MCI, CDR-SB, and CDR were not statistically significant with use of galantamine versus placebo in improving cognition and function in patients with MCI. Raskind...
Cholinergic Therapy for Alzheimer's Disease
Cholinergic Therapy for Alzheimer's Disease Cholinergic Therapy for Alzheimer's Disease By Morgan L. Levy, MD Abstract Cholinergic therapies such as tacrine and donepezil improve memory, language, and praxis (higher-level control of motor function) in Alzheimer's disease. Alzheimer's disease (AD) is the prototypical example, but other syndromes with a cholinergic deficit include dementia with Lewy bodies, Parkinson's disease with dementia, progressive supranuclear palsy with dementia, ...
Executive Control Function and Vascular Disease: Should We Pay More Attention to Frontal System Deficits in Patients With MCI?
Executive Control Function and Vascular Disease: Should We Pay More Attention to Frontal System Deficits in Patients With MCI? Presently, the clinical conundrum includes the initial diagnosis of MCI and the differentiation among the MCI subgroups, such as posterior cortical dementia syndrome (eg, AD), frontal system syndromes, mixed dementia syndromes, and normal aging.13 Several studies have identified MCI subclusters that may eventually lead to the development of diagnostic subgroups. ...
Progress in Mental Illness: Advances in Psychotherapeutics for the Elderly
The presentations focused on the management and Quality Indicators involved in the long-term care of elderly patients with dementia, specifically with regard to issues concerning agitation and aggression. Causes of Agitation and Aggression Factors that can lead to aggression in elderly patients include environmental issues, delirium, medications, and direct effects of neurodegenerative diseases. While both patient groups continued to decline, the donepezil-treated patients declined half as ...
Evaluation and Treatment of Benign Paroxysmal Positional Vertigo
Benign paroxysmal positional vertigo (BPPV) is characterized by brief periods of vertigo triggered by a change in the position of the patient?s head relative to gravity. The diagnosis of BPPV is based on the patient?s history and eye movements (nystagmus) evoked during two positional tests: the Dix-Hallpike maneuver and the ?supine with lateral head turns? maneuver. The direction and characteristics of the nystagmus found during the positional testing enable the clinician to determine the canal involved. Once the involved canal is identified, BPPV may be effectively treated with a physical maneuver. The maneuvers may be performed by a clinician or by patients themselves. (Annals of Long-Term Care: Clinical Care and Aging 2007;15[6]:33-39)
An Update on Parkinson's Disease and Its Psychiatric Complications
An Update on Parkinson's Disease and Its Psychiatric Complications June 2004An Update on Parkinson's Disease and Its Psychiatric Complications Mark A. Menza, MD, Margery H. Mark, MD, Dag Aarsland, MD, PhD, Laura Marsh, MD, Constantine G. Lyketsos, MD, MHS Download Article PDF A symposium entitled ? s disease, depression, and anxiety; the prevalence of cognitive impairment, dementia, and sleep disorders among patients with Parkinson? s Disease Research Center of Excellence, Baltimore, MD. ...
Management and Treatment of Epilepsy in the Elderly
Management and Treatment of Epilepsy in the Elderly Management and Treatment of Epilepsy in the Elderly Steven C. Schachter, MD Management and Treatment of Epilepsy in the Elderly Steven C. Schachter, MD Dr. Schachter is Medical Director, Clinical Trials, at Beth Israel Deaconess Medical Center and Associate Professor of Neurology, Harvard Medical School, Boston, MA. Clinical Presentation of Seizures in the Elderly Elderly patients with epilepsy nearly always have partial seizures, and CPS ...
An Update on Parkinson's Disease and Its Psychiatric Complications
An Update on Parkinson's Disease and Its Psychiatric Complications June 2004An Update on Parkinson's Disease and Its Psychiatric Complications Mark A. Menza, MD, Margery H. Mark, Dag Aarsland, MD, PhD, Laura Marsh, MD, Constantine G. Lyketsos, MD, MHS A symposium entitled ? s disease, depression, and anxiety; the prevalence of cognitive impairment, dementia, and sleep disorders among patients with Parkinson? s Disease Research Center of Excellence, Baltimore, MD. Parkinson?s disease is ...
Diagnostic Challenges and Treatment Options: Case Presentation on Cognitive Decline and Dementia
The early diagnosis and treatment of Alzheimer?s disease brings benefit to the patient, his or her family, and the caregivers. Slowing or delaying the progression of disease reduces morbidity, improves functional independence, and decreases overall expense. The interface between cardiovascular health and dementia affords even greater opportunity to impact the management of Alzheimer?s disease by recognizing and treating other comorbidities. As we further understand mild cognitive impairment, there may be additional opportunities to intervene even earlier. The authors present the case of a woman with short-term memory loss. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[3]:41-45)
Metrifonate Improves the Cognitive Deficits of Patients With Alzheimer's Disease Relative to Placebo Treatment and to Baseline Performance
Metrifonate Improves the Cognitive Deficits of Patients With Alzheimer's Disease Relative to Placebo Treatment and to Baseline Performance Metrifonate Improves the Cognitive Deficits of Patients With Alzheimer's Disease Relative to Placebo Treatment and to Baseline Performance Martin R. Farlow, MD, and Pamela A. Cyrus, MD *Objective: To evaluate the relative efficacy of two doses of metrifonate, a long-acting acetylcholinesterase (AChE) inhibitor, in improving the cognitive performance of ...
Salloway et al12 conducted a randomized, double-blind, placebo-controlled study of donepezil in 270 patients with MCI. A randomized, double-blind, placebo-controlled, 24-month study of galantamine in 1062 patients with MCI aimed to improve cognition and global functioning at 12 months, and to delay conversion to dementia.14 ADAS-Cog/MCI, CDR-SB, and CDR were not statistically significant with use of galantamine versus placebo in improving cognition and function in patients with MCI. Raskind...
Cholinergic Therapy for Alzheimer's Disease Cholinergic Therapy for Alzheimer's Disease By Morgan L. Levy, MD Abstract Cholinergic therapies such as tacrine and donepezil improve memory, language, and praxis (higher-level control of motor function) in Alzheimer's disease. Alzheimer's disease (AD) is the prototypical example, but other syndromes with a cholinergic deficit include dementia with Lewy bodies, Parkinson's disease with dementia, progressive supranuclear palsy with dementia, ...
Executive Control Function and Vascular Disease: Should We Pay More Attention to Frontal System Deficits in Patients With MCI? Presently, the clinical conundrum includes the initial diagnosis of MCI and the differentiation among the MCI subgroups, such as posterior cortical dementia syndrome (eg, AD), frontal system syndromes, mixed dementia syndromes, and normal aging.13 Several studies have identified MCI subclusters that may eventually lead to the development of diagnostic subgroups. ...
The presentations focused on the management and Quality Indicators involved in the long-term care of elderly patients with dementia, specifically with regard to issues concerning agitation and aggression. Causes of Agitation and Aggression Factors that can lead to aggression in elderly patients include environmental issues, delirium, medications, and direct effects of neurodegenerative diseases. While both patient groups continued to decline, the donepezil-treated patients declined half as ...
Benign paroxysmal positional vertigo (BPPV) is characterized by brief periods of vertigo triggered by a change in the position of the patient?s head relative to gravity. The diagnosis of BPPV is based on the patient?s history and eye movements (nystagmus) evoked during two positional tests: the Dix-Hallpike maneuver and the ?supine with lateral head turns? maneuver. The direction and characteristics of the nystagmus found during the positional testing enable the clinician to determine the canal involved. Once the involved canal is identified, BPPV may be effectively treated with a physical maneuver. The maneuvers may be performed by a clinician or by patients themselves. (Annals of Long-Term Care: Clinical Care and Aging 2007;15[6]:33-39)
An Update on Parkinson's Disease and Its Psychiatric Complications June 2004An Update on Parkinson's Disease and Its Psychiatric Complications Mark A. Menza, MD, Margery H. Mark, MD, Dag Aarsland, MD, PhD, Laura Marsh, MD, Constantine G. Lyketsos, MD, MHS Download Article PDF A symposium entitled ? s disease, depression, and anxiety; the prevalence of cognitive impairment, dementia, and sleep disorders among patients with Parkinson? s Disease Research Center of Excellence, Baltimore, MD. ...
Management and Treatment of Epilepsy in the Elderly Management and Treatment of Epilepsy in the Elderly Steven C. Schachter, MD Management and Treatment of Epilepsy in the Elderly Steven C. Schachter, MD Dr. Schachter is Medical Director, Clinical Trials, at Beth Israel Deaconess Medical Center and Associate Professor of Neurology, Harvard Medical School, Boston, MA. Clinical Presentation of Seizures in the Elderly Elderly patients with epilepsy nearly always have partial seizures, and CPS ...
An Update on Parkinson's Disease and Its Psychiatric Complications June 2004An Update on Parkinson's Disease and Its Psychiatric Complications Mark A. Menza, MD, Margery H. Mark, Dag Aarsland, MD, PhD, Laura Marsh, MD, Constantine G. Lyketsos, MD, MHS A symposium entitled ? s disease, depression, and anxiety; the prevalence of cognitive impairment, dementia, and sleep disorders among patients with Parkinson? s Disease Research Center of Excellence, Baltimore, MD. Parkinson?s disease is ...
The early diagnosis and treatment of Alzheimer?s disease brings benefit to the patient, his or her family, and the caregivers. Slowing or delaying the progression of disease reduces morbidity, improves functional independence, and decreases overall expense. The interface between cardiovascular health and dementia affords even greater opportunity to impact the management of Alzheimer?s disease by recognizing and treating other comorbidities. As we further understand mild cognitive impairment, there may be additional opportunities to intervene even earlier. The authors present the case of a woman with short-term memory loss. (Annals of Long-Term Care: Clinical Care and Aging 2005;13[3]:41-45)
Metrifonate Improves the Cognitive Deficits of Patients With Alzheimer's Disease Relative to Placebo Treatment and to Baseline Performance Metrifonate Improves the Cognitive Deficits of Patients With Alzheimer's Disease Relative to Placebo Treatment and to Baseline Performance Martin R. Farlow, MD, and Pamela A. Cyrus, MD *Objective: To evaluate the relative efficacy of two doses of metrifonate, a long-acting acetylcholinesterase (AChE) inhibitor, in improving the cognitive performance of ...