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Biomedical subjects

G T Grossberg

Publications and source records attributed to G T Grossberg.

At least 37 records · Page 2Linked to original sources
PubMed1994

The use of psychotropic medication in the management of problem behaviors in the patient with Alzheimer's disease.

Although a variety of potential alternatives to the neuroleptics in the management of agitated behavior in Alzheimer's disease exist, more large, well-controlled studies are needed. At present, neuroleptics remain the standard treatment for this problem. It is also important for the clinician to investigate thoroughly underlying instigators of behavior change in Alzheimer's patients, such as delirium, anxiety, depression, or environmental factors, and target treatment to these disorders.

Adrenergic beta-Antagonists↗
PubMed1994

Drinking behavior and vasopressin responses to hyperosmolality in Alzheimer's disease.

Individuals with Alzheimer's disease (AD) have been shown to have abnormalities in response to fluid restriction. Twelve subjects with AD and ten elderly controls underwent overnight fluid restriction followed by measurement of plasma and urine vasopressin and serum osmolality. Estimates of "thirst" were determined after one hour of ad libitum water intake. All subjects were tested with a Mini-Mental State Examination (MMSE) and Global Deterioration Scale (GDS). Individuals with AD had a greater degree of overnight dehydration than the elderly control group (serum osmolality 310 +/- 1 vs. 305 +/- 1 mosmol/kg, p = 0.02). There was no difference between the groups in the plasma or urinary levels of vasopressin. There was a direct correlation (r = 0.45, p = 0.03) of the amount of water intake as a measure of "thirst" with the MMSE score as a measure of cognitive functioning. Individuals with advanced cognitive impairment may be at risk of dehydration due to loss of protective "thirst" responses with secondary complications of dehydration.

Aged↗
PubMed1994

Occurrence of cancer in Alzheimer and elderly control patients: an epidemiologic necropsy study.

Epidemiologic necropsy provides an accurate measure of the occurrence rates of diseases. To determine the occurrence of cancer in Alzheimer patients as well as in non-Alzheimer elderly controls, we examined autopsy reports of 575 control and 71 Alzheimer cases aged 50-100 years for histologic evidence of cancer. We compared expected rates of cancers calculated from the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) Program data to rates observed at autopsy using a chi-squared test. To determine whether there was an association between the occurrence of cancer and Alzheimer disease, we compared rates for all cancer and three specific cancers in Alzheimer and control patients using an odds ratio test. We found from fourfold to 98-fold more cancer in Alzheimer patients and controls than that expected from SEER data. There was no statistical difference in the autopsy incidence of total, lung, or prostate cancer between Alzheimer patients and controls. However, the occurrence of pancreatic cancer was 6.7-fold higher in Alzheimer patients than in control subjects. Controlling for multiple comparisons, the odds ratio for pancreatic cancer in Alzheimer's disease was significantly higher than in controls (p < 0.001). Our results indicate that cancer occurs more frequently than expected in both Alzheimer patients and control subjects. In addition, there may be an association between the occurrence of certain cancers and Alzheimer's disease.

Aged↗
PubMed1992

The effect of a single low dose of trihexyphenidyl on memory functioning in the healthy elderly.

Medications with anticholinergic properties, when taken at therapeutic doses, are known to adversely affect memory functioning in young adults and the elderly. However, their impact at lower doses in geriatric persons has been less thoroughly studied. We investigated the impact of a single 2-mg dose of trihexyphenidyl on memory functioning in 20 healthy elderly subjects using a within-subjects, double-blind comparison with a placebo. Memory functioning was evaluated using subtests of the Wechsler Memory Scale. Subjects also rated the perceived impact of medication on their performance following memory testing. Results indicated that the single 2-mg dose of trihexyphenidyl produced impaired performance on measures of immediate and half-hour delayed recall of complex verbal and visual material when compared to the placebo condition. However, differences were not found on several other memory measures, including general orientation, attention-concentration, and learning of word associations. The significance of these selective memory deficits and suggestions regarding future research are discussed.

Aged↗
PubMed1991

Late onset panic disorder: evidence from a study of patients with chest pain and normal cardiac evaluations.

In the context of administering psychiatric diagnostic interviews to cardiology patients with chest pain and no evidence of coronary artery disease, the authors found twenty-seven patients over the age of sixty-five, nine (33%) of whom fit panic disorder criteria. Their mean age of onset was sixty-two (SD = 23 years). Only two patients reported onset of panic disorder earlier than age sixty-two. All nine were widows while the comparison group of non-panic subjects over age sixty-five included only seven of eighteen (40%) who were widows. These findings suggest panic disorder may be prevalent in older patients with chest pain and no evidence of coronary artery disease and that panic disorder may begin later in life.

Aged↗
PubMed1991

Insomnia in the elderly.

Insomnias lead the list of sleep disorders in the elderly. The differential diagnosis includes poor sleep habits, medical and psychiatric disorders, and drug interactions. Effective treatment includes sleep hygiene education and avoidance of substances known to interfere with sleep. In general, anticholinergic agents, antihistamines and long-half-life benzodiazepines should be avoided as hypnotic agents in the elderly. Safer therapeutic options include relaxation therapy and the short-half-life benzodiazepines without active metabolites.

Aged↗
PubMed1990

A preliminary comparison of healthy elderly and young adults on the SUNYA Revision of the Psychosomatic Symptom Checklist.

Elderly (n = 30) and young (n = 30) subjects, equated in terms of general physical health, education and depression, were compared in terms of Total, Frequency and Intensity scores on the psychosomatic symptom checklist (PSC). Elderly subjects scored significantly lower than young subjects for both PSC Total and PSC Intensity scores. These results call into question the practice of aggregating PSC data from age heterogeneous samples and indicate the importance of reporting all three PSC scores.

Adolescent↗
PubMed1990

Geriatric psychiatry consultations in a university hospital.

A review was conducted of the records of 147 patients above the age of 60 in a 350-bed general university hospital for whom a request for consultations was made over a two-year period by a geriatric psychiatry division in a department of psychiatry. Findings were compared with those obtained by Mainprize and Rodin and by Ruskin. Most referrals in the present study were from internal medicine as they were in the other two studies. The principal reason for referrals in this and in Mainprize and Rodin's study was depression (48% and 37%, respectively) but not in Ruskin's study (10%). The primary DSM-III-R diagnoses of the referred patients in this study were affective disorder (27%), adjustment disorders (26%), and dementia (22%). Affective disorder was also the most frequent diagnosis in Ruskin's study. Psychotropic medication was the most frequently cited recommendation in all three studies.

Aged↗
PubMed1989

Age differences in body consciousness.

Physical changes associated with the aging process have both private and public components, and this study investigated the degree to which elderly persons attend to these changes. Sixty subjects, elderly (n = 30) and young (n = 30), equated in terms of physical health, education, and depression, were compared on measures of private body consciousness, public body consciousness, and body competence. Results indicated that healthy elderly persons are more conscious of their external physical appearance and are more positive in their self-evaluations of body competence than are young subjects.

Adolescent↗
PubMed1989

Vasopressin response to dehydration in Alzheimer's disease.

Alzheimer's disease is a progressive deterioration of neuropsychological functioning. One of the main neuropathological correlates of the disease is a drop-out of cholinergic neurons within the central nervous system. The neuropeptide that is responsible for water homeostasis and defense against dehydration, vasopressin, is also under direct cholinergic control. Several studies have suggested that in Alzheimer's disease there has been a trend toward lower vasopressin levels than in age-matched controls. In order to improve discrimination of normal from diminished vasopressin levels, nine subjects with Alzheimer's disease (mean age 65 +/- 2 years) and nine age- and sex-matched controls (68 +/- 3 years) underwent a mild provocative challenge of overnight fluid restriction. Individuals with Alzheimer's disease had a greater degree of dehydration, with overnight serum osmolality of 313 +/- 4 vs 300 +/- 3 Mosmol/kg, P = .01, and diminished "thirst" as measured by water ingested in one hour of ad libitum water intake. Eight of the nine with Alzheimer's disease had levels of vasopressin which, by extrapolation, appear to be subnormal for their serum osmolalities, whereas seven of the nine control subjects has vasopressin levels within or above the reference range (P less than .05). Elderly individuals with Alzheimer's disease may be at increased risk of dehydration during periods of fluid restriction due to the loss of normal physiological responses of "thirst" and vasopressin secretion.

Aged↗
PubMed1987

Phenylethanolamine N-methyltransferase activity is decreased in Alzheimer's disease brains.

Phenylethanolamine N-methyltransferase (PNMT) is the rate-limiting enzyme involved in the synthesis of epinephrine and a specific marker for epinephrine neurons. We have previously described the stability of this enzyme in a variety of pre- and postmortem conditions in human brain autopsy specimens and demonstrated its presence in areas of the human brain that are associated with memory and attention. We now report on 5 patients with Alzheimer's disease (AD) who had a decrease in PNMT activity of 37 to 48% in areas of the brain affected by the disease but not in the cerebellum, an area of the brain unaffected by the disease. The degree of decrease in PNMT activity in the hippocampus correlated significantly with the degree of dementia. We have provided direct immunochemical evidence that the decrease in PNMT activity in AD is due to the loss of this specific enzyme protein.

Aged↗