Search PubMed⌕ Search

Biomedical subjects

C Eisdorfer

Publications and source records attributed to C Eisdorfer.

At least 73 records · Page 4Linked to original sources
PubMed1985

Health care and the elderly.

America's health care crisis is hitting our elderly and threatens to cripple Medicare, the elderly's financial support system. Medicare was designed to ensure that every elderly American would be protected against the destruction of life savings as a result of illness. Elderly Americans would be able to enjoy their golden years without the financial burden of medical bills. Today, this vision is almost extinct. Medicare has been placed on the endangered species list. Market predictions indicate that Medicare's Hospital insurance Trust Fund will be depleted by 1988 if current trends continue. The elderly presently must pay on the average about 14% of their health care bill. In addition, Medicare pays little for long-term care; and about 45% of long-term care is paid for out-of-pocket by the elderly and their families. Alternative approaches are desperately needed of Medicare if our elderly are to survive.

Aged↗
PubMed1984

Phases of change in the patient with Alzheimer's dementia: a conceptual dimension for defining health care management.

Since the progressive nature of Alzheimer's disease and related disorders of later life gradually imposes a series of significant limitations upon the patient, a successful clinical management program rests upon a conceptualization of changes in the patient. Postulating psychologic reactions helps professionals to understand and respond to the patient's needs and feelings at different stages of the disease. The phases discussed here provide the basis for defining treatment goals and management plans, selecting therapeutic strategies, identifying needed resources, and evolving innovative approaches to patient care.

Adaptation, Psychological↗
PubMed1983

Sleep disturbances in the institutionalized aged.

One hundred eighty nursing home residents, not psychotic or demented, average age 82 years, were administered a 30-minute structured interview to identify and characterize their sleeping patterns, health status, medications, psychosocial environment, and living conditions. In addition, both the residents and the night nurses rated quality of sleep on a five-point scale. Residents and nurses on all shifts also rated appetite and exercise on five-point scales. Residents were classified as having a sleep disturbance if they met at least one of the following criteria and reported poor sleep quality: onset of sleep latency greater than 30 minutes, three or more nighttime awakenings, and less than six hours sleep per night. Forty-five per cent of the residents met at least one clinical research criterion. Residents with sleep disturbance rated their sleep quality significantly lower than their peers not meeting research criteria. However, the nurses' ratings did not discriminate problem sleepers, and they correlated poorly with the residents' ratings. These subjective patient evaluations are discussed in relation to nursing evaluations, prescription of hypnotic medications, and other variables.

Aged↗
PubMed1983

The desk directory of social resources: a physicians' reference guide to social and community services for the aged.

Physicians not only have a responsibility for the diagnosis and management of illness in the aged but also must address the patient's emotional needs, functional status, and psychosocial problems. The Institute of Medicine Report on Geriatric Medical Education has emphasized the need to train physicians to understand how the social components of care enhance the course and outcome of treatment. A physician's reference guide to social and community services should be developed to provide information that will enable clinicians to integrate medical and community health services into their practice.

Aged↗
PubMed1982

Changes in the sleep and waking EEGs of nondemented and demented elderly subjects.

Sleep and waking EEGs from 11 healthy nondemented elderly men and from ten inpatients for whom the diagnosis was probable senile dementia of Alzheimer's type (SDAT), were monitored in the subjects' typical home or ward environments or in the sleep laboratory, according to their customary sleep schedules. Aged normal subjects (age range, 56-85 years) had less Stage 3 and Stage 4 sleep, less REM sleep, and more wakefulness than normally observed in young adults. Patients with SDAT (age range, 56-88 years) had even less Stage 3 sleep, no Stage 4 sleep, and very little REM sleep, and experienced fragmentation of their sleep, with frequent awakenings. These sleep variables were significantly different in the SDAT and control groups (MANOVA). Examination of the 24-hour plots of sleep/waking patterns revealed prominent fragmentation of the diurnal sleep/waking rhythm in SDAT patients, with frequent daytime napping and nighttime periods of wakefulness. In addition, significant group differences were observed for the EEG variable, dominant occipital frequency. More qualitative EEG variables (diffuse slowing, spindle activity, and paroxysmal discharges) also differed between groups. It is suggested that correlative neuropathologic data might provide an understanding of the basis for the sleep, EEG, and mental-function factors that undergo change in SDAT.

Aged↗
PubMed1982

Alzheimer's disease and maternal age.

Findings from several studies suggest a relationship between Alzheimer's disease and Down's syndrome. It has long been known that advanced maternal age is a risk factor for Down's syndrome, and that mothers who give birth to a child with this syndrome have characteristics consistent with accelerated aging. Little is known about risk factors for Alzheimer's disease, other than age. In this study, documentation is supplied for a hypothesis concerning a relationship between Alzheimer's disease and advanced maternal age.

Aged↗
PubMed1982

Stress and psychopathology in the aged.

There is a general agreement that the elderly experience a higher proportion of significant life event changes than the younger adult population, and research suggests that life event changes often precede episodes of psychiatric illness. It is also evident, however, that most people over 60 successfully adapt to their changing circumstances without psychiatric disorders. Clearly, the presence of certain physical, psychological, and social mediators may modify the stress response in a predictable fashion. Off-time life events, absence of a confidante, and intrapunitive personality, and a dependence on alcohol, psychotropic, and sedative/hypnotic medications are all examples of mediators that indicate an individual who may be at risk. It is our hope that researchers will continue to identify specific risk factors associated with psychiatric illness in the elderly for use in designing specific prevention and intervention programs for those at risk.

Adaptation, Psychological↗
PubMed1981

Histocompatibility antigens (HLA) and patterns of cognitive loss in dementia of the Alzheimer type.

Recent data suggest that a proportion of patients with primary neuronal degeneration of the Alzheimer type have the HLA-B7 antigen. However, the possibility that other differences might exist between patients with and without the marker has not been examined. We tested a range of cognitive skills in Alzheimer patients with and without the HLA-B7 to examine whether those individuals with the HLA marker would exhibit a profile of cognitive loss different from those without it. Our results indicate that patients with HLA-B7 antigens had selective attentional scores that were significantly lower than Alzheimer patients without the antigen. Neither group was significantly different in either memory capacity or retrieval from short-term and long-term memory. The data support the hypothesis that there may be more than one disorder in what is now referred to as dementia of the Alzheimer type.

Alzheimer Disease↗
PubMed1981

Dementia and other competing risks for mortality in the institutionalized aged.

The relative importance of dementia, gender, age and functional status (FS) was examined for relationships to mortality within five years after admission of the subjects to a New York City nursing home for the aged. Using a random sample of 212 of the nursing home's patients, a statistical model was developed to estimate the relative risk of mortality. When this model was cross-validated on an independent sample of 118 residents, it failed to show significant lack of fit. Given these results, an international model was developed by combining the New York City samples(N = 330) and comparing them to a sample (N = 363) from a nursing home in Tokyo, Japan. In the new York model, gender was the most important predictor, with age and dementia next in importance; FS was not a significant predictor. Despite the apparent differences in the types of dementia in the New York and Tokyo nursing homes, the mortality patterns were similar.

Age Factors↗
PubMed1981

Concentrations of desipramine in elderly women.

Seven elderly depressed women were given desipramine, and plasma concentrations of the drug were measured from blood samples drawn after a single dose and during long-term use. The concentrations were no different from those found in younger patients. Aging does not seem to alter the plasma concentration of desipramine, and the authors conclude that the increased incidence and severity of the drug's side effects are probably not due to high drug concentrations.

Aged↗
PubMed1981

Care of the aged: the barriers of traditions.

The growing population of older persons in our society will require increased attention. It is contended that the current pattern of third-party reimbursement for hospitalization and technical procedures focuses upon acute care and cure. The philosophy underlying medical education and practice is a barrier to the provision of quality care to older persons with chronic disorders. A changing emphasis for future practice is indicated.

Aged↗
PubMed1981

Management of the patient and family coping with dementing illness.

The treatment objective of medical care for the demented patient is to maximize the level of functioning and the quality of life for both the patient and the family or caregivers. The majority of patients with dementia are in the community, and most families prefer to keep their relatives out of institutions as long as possible, usually until the family's resources are exhausted. The impact of dementing illness on family health can be severe, and family members can develop physical and psychiatric disorders. The physician can perform a range of important functions in the management of the patient and family and 12 are listed which may serve as a guide for clinical practice.

Dementia↗
PubMed1980

Electrodermal reactivity: an analysis by age and sex.

Resting electrodermal levels and electrodermal response to Valsalva maneuver were measured in males and females of three age groups (young, middle-aged, old). Significant sex and age effects were observed. Young and middle-aged females had lower electrodermal resting levels than males. These differences were reversed for the young age group during a Valsalva maneuver, where the females larger specific responses. With old age, sex differences diminished, resting state conductance levels decreased, but the specific conductance responses to Valsalva remained relatively unchanged. Results demonstrate interactive age and sex effects on the electrodermal measure. Possible relevance of the data to sex differences in adaptation and stress response are discussed.

Adult↗
PubMed1980

Antinuclear antibodies in the cognitively impaired elderly.

The frequency of antinuclear antibodies was evaluated in older men and women aged 60 to 100 years with presumptive diagnoses of chronic brain syndrome or dementing illness. Thirteen per cent of the women and none of the men with organic brain syndrome had positive titers, compared to 3% for older men and women aged 60 to 89 years evaluated in a medical clinic population. It would appear to be valuable to evaluate the significance of antinuclear antibodies and other autoantibodies in the pathogenesis of dementing illness in the elderly.

Aged↗
PubMed1980

A clinic for the impaired elderly and their families.

The need for improving psychiatric services to the elderly and for recognizing the importance of the family in caring for the impaired elderly led to the establishment of the Geriatric and Family Services, an outpatient clinic. This clinic provides psychiatric, medical, social, nursing, and architectural evaluations and recommendations for impaired older persons and also provides support and practical advice to the family. Most of the clinic's patients suffer from a dementing illness; of this group most have dementia of the Alzheimer's type. The authors studied the appointment-keeping behavior of the patients and also surveyed the patients' families as an indication of the clinic's success. Out of 50 patients the broken-appointment rate, as well as the drop-out rate, was 2%; 90% of the families who responded to the questionnaire indicated they would recommend the clinic's services to others.

Adaptation, Psychological↗