Biomedical subjects

A C Coyne

Publications and source records attributed to A C Coyne.

At least 19 recordsLinked to original sources

PubMed2000

Primary vs subspecialty care: a structured follow-up of dementia patients and their caregivers.

All dementia patients and their caregivers who had received a University-based comprehensive evaluation and a diagnosis of Alzheimer's disease during 1997 (N = 80) were surveyed 1 year after their initial assessment. Of the original cohort, 72.5% were contacted, and two subgroups were defined: 31 patients were being seen only by their primary care physicians (MED), and 27 patients were being treated in addition by a geriatric psychiatry faculty member (GERO). There were statistically significant differences between the two groups (MED vs. GERO, respectively) at follow-up in terms of: 1) hospitalization (39% vs. 15%; P<O.05); 2) cognitive status (P<O.05); and 3) prescription of donepezil at follow-up (35% vs. 64%; P<O. 005). These differences need to be assessed in a larger-scale prospective study.

Aged↗

PubMed2000

Effectiveness of nursing home staff as managers of disruptive behavior: perceptions of nursing directors.

Nursing directors of 899 geographically diverse skilled nursing facilities reported substantial limitations in the competence of staff at all levels in managing behaviorally disturbed patients and a broad-based need for improvements in skills. The authors propose an interdisciplinary team training model as an appropriate design for improving competence and promoting collaborative care.

Attitude of Health Personnel↗

PubMed1998

Psychiatric consultation in the nursing home. A survey of six states.

The authors examined availability, characteristics, and perceived adequacy of psychiatric consultation in nursing homes, as reported by directors of nursing, who returned 899 questionnaires. Thirty-eight percent of nursing home residents were judged to need a psychiatric evaluation; current frequency of consultation was rated as adequate by half of nursing directors. Nearly two-thirds reported that psychiatrists adequately provided diagnostic and medication recommendations; however, advice on nonpharmacologic management techniques, staff support, and dealing with staff stress and family conflicts was largely viewed as inadequate. Findings suggest that perceived need for psychiatric services is far greater than the level actually provided. Overall, more attention must be directed to identifying incentives for psychiatrists to practice in nursing homes, determining clinical effectiveness of mental health services, and examining effects of alternative payment mechanisms on level of care.

Humans↗

PubMed1998

Past utilization of geriatric psychiatry outpatient services by a cohort of patients with major depression.

The authors examined past utilization of outpatient psychiatric services by elderly depressed patients. A chart review identified 49 patients (mean age = 69.4) who had ceased active treatment, of whom 28 were successfully contacted. Reasons for discontinuation were 1) patient perception that care was no longer needed (51.5%); 2) existence of barriers to care (33.3%); and 3) perception that treatment was ineffective (15.2%). Findings included 1) a higher number of visits by patients referred from a non-healthcare source and by married patients; 2) lower Beck Depression Inventory scores among those who reported that they did not need additional treatment; and 3) a greater willingness to re-engage in treatment by those patients with a higher number of visits during their previous treatment. Patient characteristics and source of referral were associated with both past service utilization and likelihood of future usage; however, many individuals do not access treatment because of both practical and attitudinal barriers to care.

Aged↗

PubMed1996

Negative symptoms in Alzheimer's disease.

OBJECTIVE: This study was undertaken to demonstrate that negative symptoms are prominent in patients with Alzheimer's disease and are distinct from depression. METHOD: patients with Alzheimer's disease (N=24) and a group of cognitively intact older adults (N=26) were compared in terms of scores on the Scale for the Assessment of Negative Symptoms in Alzheimer's Disease. RESULTS: Negative symptoms were more severe in patients with Alzheimer's disease than in the healthy elderly comparison subjects. Among the patients with Alzheimer's disease, negative symptoms were correlated with dementia severity. CONCLUSIONS: Patients with Alzheimer's disease display little interest in self-care, work and household tasks, social and family activities, and emotional needs of others, despite an absence of depressive symptoms, positive symptoms, comorbid systemic illnesses, or medication exposure. Such negative symptoms may contribute to functional disability and thus complicate management of such patients.

Affective Symptoms↗

PubMed1995

Depressive symptoms in Alzheimer's disease and multi-infarct dementia.

We examined the prevalence of major depression, depressed mood/anhedonia, and subjective and neurovegetative symptoms of depression that were unaccompanied by depressed mood/anhedonia in patients with clinically-diagnosed Alzheimer's disease (AD) and multi-infarct dementia (MID). The specificity of subjective and neurovegetative depressive symptoms for depressed mood in dementia was examined, as was the impact on depression of clinical variables such as family history, patient age, and dementia severity. Subjects were 105 outpatients who met DSM-III-R criteria for AD (n = 67) or MID (n = 38). Depressed mood/anhedonia was frequently noted in both the AD (40.3%) and MID (34.2%) groups. One or more depressive symptoms, not accompanied by depressed mood/anhedonia, were also common in AD and MID (49.3% and 36.8%, respectively). Major depression was relatively uncommon in AD (10.5%) but was noted more frequently in MID (29.0%). Among AD patients, neurovegetative symptoms of depression were not any more common in patients with depressed mood/anhedonia than in those without depressed mood/anhedonia. Subjective symptoms of depression were also not significantly associated with depressed mood/anhedonia. The study highlights the importance of viewing major depression, depressed mood-anhedonia, and other depressive symptoms (subjective and neurovegetative) as separate entities in AD and MID.

Aged↗

PubMed1993

Characteristics of older adults referred to a psychiatric emergency outreach service.

Although older adults typically underutilize mental health services, problems associated with dementing illnesses, chronic medical illnesses, affective disorders, social isolation, and multiple medication use, among other phenomena, have increased referrals of the elderly to psychiatric emergency services. The present study reviewed characteristics of elderly adults referred to a psychiatric emergency outreach/screening service. Of all individuals for whom a referral was made, 24% were aged 60 or older. Among those older adults referred, 63% were seen by screening service personnel; 37% did not meet screening criteria or voluntarily sought mental health services. Diagnoses of individuals evaluated included dementia (27%), affective disorders (27%), schizophrenia (16%), psychosis (12%), alcohol abuse (7), and diagnosis deferred (11%). Findings highlight the limited options available for mental health care of the aged.

Academic Medical Centers↗

PubMed1993

A retrospective study of syphilis seropositivity in a cohort of demented patients.

A retrospective study of 376 patients with dementia was performed to determine the rate of syphilis seropositivity. Subjects were seen over a 2.5-year period and received medical, social, psychiatric, neurological, and laboratory evaluations. Mean age was 74 years and 73% were women. Diagnoses included Alzheimer's disease (AD; 29.8%), vascular dementia (VascD; 24.7%), combined AD/VascD (14.3%), and other diagnoses (31.2%). Dementia was moderately advanced with a mean Folstein Mini-Mental State Score of 16. Fluorescent treponemal antibody absorption tests (FA) were performed on 338 of the patients with 10.9% being reactive. Two of nine subjects with reactive FA's had reactive rapid plasma reagin tests.

Adult↗

PubMed1993

The relationship between dementia and elder abuse.

OBJECTIVE: Alzheimer's disease and other dementias may be associated with greater risk for physical abuse than other illnesses of the elderly. The authors examined the relationship between dementia and abusive behavior in a group of demented patients and their caregivers. METHOD: An anonymous questionnaire was distributed to 1,000 caregivers who called a telephone help line specializing in dementia. Demographic characteristics of patients and caregivers were assessed, the occurrence of abuse was examined, and caregivers completed the Zarit Burden Interview and the Zung Self-Rating Depression Scale. RESULTS: Questionnaires were completed by 342 caregivers. The mean age of caregivers was 56.1 years; 163 (54.5%) were adult children caring for parents, 111 (37.1%) cared for spouses, and 25 (8.4%) cared for other relatives. Thirty-three caregivers (11.9%) reported that they had directed physically abusive behavior (e.g., pinching, shoving, biting, kicking, striking) toward the dementia patient in their care. These caregivers had been providing care for more years, cared for patients functioning at a lower level, displayed higher burden scores, and displayed higher depression scores than caregivers who reported no abuse. In addition, 92 caregivers (33.1%) reported that the patient directed abuse toward them during the course of providing care. Caregivers who had been abused by patients, in comparison to those who had not, were more likely to direct abusive behavior back toward the patient in their care. CONCLUSIONS: These results support the hypothesis that abuse involving cognitively impaired older adults and their caregivers may be associated with the relatively high psychological and physical demands placed on family members who care for relatives with dementia.

Aggression↗

PubMed1993

Diagnosis of multi-infarct dementia: predictive value of clinical criteria.

Clinical and neuroimaging features that best discriminated a multi-infarct dementia diagnosis from a diagnosis of Alzheimer's disease were retrospectively reviewed for 192 patients of a university-based dementia diagnostic clinic. Only a subset of features usually ascribed to multi-infarct dementia actually distinguished that diagnosis from the diagnosis of Alzheimer's disease.

Aged↗

PubMed1991

Information and referral service usage among caregivers for dementia patients.

Questionnaires were mailed to 257 callers of a toll-free telephone "helpline" specializing in Alzheimer's disease and related dementing illnesses; 125 (48.6%) were completed and returned. On the average, 3.94 requests for information were made per call. The most common requests concerned services delivered to the home, general information about dementia, information about adult day care, and support group information. Results indicated that a telephone-based information and referral helpline is useful in disseminating knowledge about resources to caregivers of older community-residing adults with cognitive impairment.

Adult↗

PubMed1990

The diagnosis of dementia: demographic characteristics.

The demographic characteristics of 242 clinic outpatients evaluated for dementia were examined. Each individual received a comprehensive assessment of medical status, psychological functioning, and social abilities. Diagnoses were arrived at by consensus, and appropriate treatment plans and follow-up recommendations were generated, with comprehensive feedback provided to family members and other caregivers. The results of this study help increase our knowledge of the characteristics of individuals with Alzheimer's disease, multi-infarct dementia, or other related disorders.

Aged↗

PubMed1989

Are there age differences in chunking?

We examined the ability of younger and older adults to organize letter sequences in memory when no external inducement of chunking was used. In order to do so, subjects were tested on a paired-associate, serial recall task. From these data the number of completely recalled sequences was computed, as well as global and stop transitional error probabilities (TEPs). Older adults recalled fewer correct letter sequences than did the young adults, but the global and stop TEP data indicated that both age groups were chunking the four-letter sequences into two sets of two letters. Thus, the present study indicates that there are no age differences in primary organization, but that older adults exhibit an age deficit in serial recall.

Adult↗

PubMed1987

Adult age, information processing, and partial report performance.

Previous investigations using the partial report technique for examining adult age differences in iconic memory have suggested that older adults are less able to extract information stored in the icon than are young adults. The present study examined the hypothesis that poorer partial report performance on the part of older adults involves age-related differences in the speed of visual and auditory information processing. Elderly (M = 67 years) and young (M = 23.5 years) adults were contrasted on partial report, whole report, backward masking, and choice reaction time tasks. Results indicated that the older age group exhibited a smaller partial report advantage than did their younger counterparts. This age difference was found to be related in part to increases with age in the time required to encode and identify visual stimuli but was not related to the time required to translate auditory cues into recall instructions. In other words, the slowdown in visual information processing speed that accompanies increased age contributes to age differences in performance on tasks involving iconic memory.

Adult↗

PubMed1986

Influence of adult age on primary and secondary memory search.

We compared young and elderly adults on the ability to search lists of words stored in primary memory (PM) and in secondary memory (SM). The results of Experiment 1 indicated that age differences in search performance were greatest under SM conditions. Older adults, unlike the young, appeared biased toward responding that probe items were not members of the memory sets stored in SM. As a result of this apparent bias, older adults committed a large number of errors on trials in which the probe was a member of the memorized list (i.e., positive probe trials) yet few errors on trials in which the probe was not a member of the list (i.e., negative probe trials). In addition, the responses of older, but not younger, adults to negative probe trials were found to be more rapid than were those to positive probe trials. In Experiment 2 we examined this pattern of responding and concluded that age differences were involved in the ability to encode memory sets and transfer them from PM to SM as well as in the ability to retrieve information from SM prior to conducting a memory search.

Adolescent↗

PubMed1984

The relationship between cognitive status and visual information processing.

The present investigation involved an examination of susceptibility to visual masking of older adults displaying evidence of Alzheimer's disease and healthy, cognitively intact older adults. Results indicated that the cognitively impaired group was more susceptible to the perceptual interference of a visual mask than was the cognitively intact group. In addition, the impaired group was found to be particularly susceptible to masking by a visual pattern (which had similar figural characteristics to target stimuli) as compared to masking by random noise (which had figural characteristics unrelated to the target). Finally, susceptibility to masking was found to be negatively correlated with performance on the Information subtest of the Wechsler Adult Intelligence Scale-Revised and with rated level of cognitive functioning. It was concluded that this pattern of results represents an acceleration of changes in perceptual processing typically associated with normal human aging.

Aging↗

PubMed1983

Age, the eye, and the visual channels: contrast sensitivity and response speed.

Age differences in spatial vision were examined by establishing contrast sensitivity functions for young and old adults. In addition, differences in the speed of operation of the different visual channels and their contribution to age differences in reaction time were assessed in a comparison of response speed to sinusoidal gratings of varied spatial frequency. An age-related loss in contrast sensitivity was observed primarily for stimuli of intermediate and high spatial frequency, an effect apparently due mostly to age-related optical differences. Reaction time varied markedly as a function of spatial frequency for the older participants, an outcome only partly attributable to age differences in target visibility. These data indicate a slowing in the speed of operations of individual visual channels and/or a change in the relationship between visual channel classes. These findings also raise a question in regard to the meaning and comparability of any studies that have used measures of response latency to the figural aspects of stimuli.

Adolescent↗

PubMed1982

Adult age differences in metamemory.

Metamemory abilities were compared among three age groups, 18 to 31, 60 to 69, and 70 to 79 years. These groups were compared with respect to their memory knowledge about the relative difficulty of memorizing low- and high-imagery and low- and high-frequency words. The three age groups were similar in their predictions of the number of words they could recall but differed in the number they actually did knowledge of these word types declines with age.

Adolescent↗