Search PubMed⌕ Search

Biomedical subjects

G J Walstra

Publications and source records attributed to G J Walstra.

6 recordsLinked to original sources
PubMed1995

Concentrations of amyloid beta protein in cerebrospinal fluid of patients with Alzheimer's disease.

Deposition of fibrillar amyloid beta protein (A beta) is increased in brains of patients with Alzheimer's disease. Concentrations of A beta were measured in cerebrospinal fluid with an enzyme-linked immunosorbent assay in 10 neurological patients free from neurodegenerative disease, 28 patients with Parkinson's disease, and 18 patients with probable Alzheimer's disease. Levels of A beta in cerebrospinal fluid were not significantly different among these groups. This observation suggests that concentrations of soluble A beta in cerebrospinal fluid as measured in this study do not reflect the amount of fibrillar, aggregated A beta in the brain of patients with Alzheimer's disease.

Aged↗
PubMed1995

Diagnosing Alzheimer's disease in elderly, mildly demented patients: the impact of routine single photon emission computed tomography.

Based on the observation of bilateral temporoparietal hypoperfusion in Alzheimer's disease (AD), single photon emission computed tomography (SPECT) is advocated by some as a powerful diagnostic tool in the evaluation of demented patients. We studied whether routine brain SPECT in elderly, mildly demented outpatients increases the a priori diagnostic sensitivity and specificity of a careful clinical examination. 99mTc-HMPAO SPECT imaging was performed in 110 patients for a first evaluation for dementia. A semiquantitative measure of temporoparietal (TP) perfusion was calculated as the ratio of the activity in the temporoparietal cortex to activity in the cerebellum. A diagnosis of probable AD according to the McKhann criteria was made in 68 patients (mean age of 79.3 years) based on the results of a clinical examination, ancillary investigations and a 6-month follow-up. TP perfusion was significantly lower in AD patients than in 18 age-matched, non-demented controls. However, at a specificity of 89%, sensitivity was only 43% for detecting probable AD. The clinicians judged that SPECT had contributed to the final diagnosis in only 8% of the demented patients investigated. Routine brain SPECT in elderly, mildly demented outpatients does not contribute substantially to diagnostic accuracy after a careful clinical examination using current diagnostic criteria. Clinical guidelines have to be developed for the use of SPECT in patients with (suspected) dementia.

Aged↗
PubMed1992

[An outpatient clinic for memory disorders; initial experiences].

The department of neurology of the Academisch Medisch Centrum started an outpatient memory clinic in 1987 for patients aged 65 and older. Its specific aims are: assessment of elderly patients with memory problems, treatment where appropriate, and advice; clinical research; teaching and training. The clinic has run full-time since 1990. The approach is multidisciplinary. We describe our findings in the first 75 patients who were referred by their general practitioners because of forgetfulness or possible dementia: 72 of them had a complete investigation; 30 patients were not demented; three could be reassured because their performance was within normal limits. Four patients were depressed and they improved on therapy. Forty-two patients were demented. All had a CT scan and comprehensive blood tests but a curable cause for the dementia syndrome was never identified. This result was expected on account of the probably low frequency of 'reversible' causes and patient selection. Secondary prevention was important when a vascular component contributed to the pathogenesis of the mental deterioration (n = 6). Even when no curable condition was found, clarity about diagnosis and prognosis was important not only to the relatives but also to the general practitioner in planning the future management of the patient. Fifty-five of the 72 patients were older than 65 years which means that we do see the patients we are particularly interested in. The clinic offers facilities for clinical research. In the project 'Diagnostiek bij dementiesyndroom' (Diagnostics in dementia syndrome) we investigate the utility of ancillary investigations in relation to the outcome in demented patients.

Aged↗
PubMed1991

[CAMDEX-N: the Dutch version of the Cambridge Examination for Mental Disorders of the Elderly with automatic data processing].

In the study of dementia four distinct categories of instruments can be distinguished: instruments to examine cognitive dysfunction, to measure the severity of dementia, to assess disturbances in daily behaviour, and instruments to make a differential diagnosis of dementia. The Cambridge Examination for Mental Disorders of the Elderly (CAMDEX), published in 1988, incorporates these four categories in a single comprehensive interview schedule. Items related to the diagnosis of clouded/delirious state, depression and other psychiatric symptoms are also included. The Dutch version (CAMDEX-N) and accompanying software for data analysis and for scientific research were developed. Items were added to the section on physical and neurological examination, and to the section on ancillary investigations. The software can be adapted to future developments in dementia research.

Aged↗