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Holly James Westervelt

Publications and source records attributed to Holly James Westervelt.

7 recordsLinked to original sources
PubMed2006

Presentation of Alzheimer's disease in patients with and without olfactory deficits.

Odor identification deficits are frequently reported in Alzheimer's disease (AD) but are not universal. This study examines differences in clinical presentation in AD patients with and without odor identification impairments. Ninety patients with probable AD were administered an odor identification test as part of a neuropsychological evaluation. Variables examined included demographic information, cognitive and behavioral measures, dementia severity, neuroimaging findings, and aspects of clinical history. Defining the groups with a median split, olfactory impaired and olfactory intact patients were mostly similar, though patients with impaired odor identification performance were more likely to be male, less likely to have a family history of dementia, and had worse visuospatial functioning. The differences noted raise the possibility of a clinical subtype of the disease.

Aged↗
PubMed2005

Assessing olfaction in the neuropsychological exam: the relationship between odor identification and cognition in older adults.

The relationship between odor identification and cognition has not been previously well characterized. The neuroanatomy of the olfactory system and the frequent finding of olfactory dysfunction in neurodegenerative diseases suggest a likely relationship between odor identification and memory, language, and executive functioning, though previous studies have often failed to demonstrate the expected relationship. The current study examined this relationship in across a continuum of ability levels (N=100). Strongest correlations were found between odor identification and language, most aspects of memory, and a measure of general cognitive functioning. Significant but more modest correlations were seen between odor identification and attention, motor, visuospatial, and executive functions. A regression analysis revealed language as the only significant predictor of olfactory performance. These findings suggest that odor identification is most closely associated with other measures of temporo-limbic functioning. The implications of these findings, particularly in consideration of the assessment of older adults, are discussed.

Aged↗
PubMed2003

Utility of the neuropsychological evaluation in an acute medical hospital.

Although recent studies have demonstrated the importance of cognitive assessment in medical settings in general, there have been no specific studies addressing the utility of the neuropsychological evaluation in the acute inpatient hospital setting. The current study examined the use of inpatient neuropsychological evaluation by treating physicians in an acute medical hospital for patient care and discharge disposition. Participants were 100 inpatients within an urban medical center who received a neuropsychological evaluation. Results showed 78% of hospital discharge summaries included information regarding the neuropsychological evaluation, 48% referenced specific results, and 68% reported specific recommendations. Further, actual placement outcomes were consistent with the neuropsychological evaluation placement recommendations 80% of the time. The current study supports the utility of neuropsychological evaluations on overall inpatient care, and discusses ways in which the results may be used to communicate the value of neuropsychological services to medical treatment and discharge planning teams, third party payors, and medical center administrators.

Female↗
PubMed2003

Odor identification deficits in diffuse lewy body disease.

OBJECTIVES: To describe odor identification performance in patients with diffuse Lewy body disease and determine the clinical utility of odor identification tests in distinguishing diffuse Lewy body disease from Alzheimer disease. BACKGROUND: The presence of olfactory deficits, especially odor identification deficits, has been well established in both Alzheimer disease and Parkinson disease. The presence of olfactory deficits in diffuse Lewy body disease is also likely given the overlap of clinical symptoms and neuropathology with Alzheimer disease and Parkinson disease. However, odor identification abilities have not been described previously in diffuse Lewy body disease. METHODS: Nine patients from a clinic sample with diffuse Lewy body disease and nine carefully matched patients with Alzheimer disease were administered an odor identification task as part of their neuropsychologic evaluations. RESULTS: Patients with diffuse Lewy body disease performed significantly worse than patients with Alzheimer disease on the odor identification test. CONCLUSIONS: Odor identification deficits may be more prevalent and severe in people with diffuse Lewy body disease than in people with Alzheimer disease, and olfactory testing may be useful in antemortem differential diagnosis of the two disorders.

Aged↗
PubMed2002

Neuropsychological functioning in chronic Lyme disease.

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.

Brain↗
PubMed2002

Referring physicians' perceptions of the neuropsychological evaluation: how are we doing?

Clinical neuropsychologists often serve as consultants to physicians. However, little is known about physicians' perceptions of the neuropsychological evaluation. Therefore, the present study examined the opinions of physicians who referred patients for neuropsychological evaluation. Surveys were mailed with the neuropsychological reports to 119 physicians who referred patients to an outpatient hospital-based neuropsychology practice over a 2-year period. Results showed that physicians requesting neuropsychological evaluations most commonly sought assistance with establishing and confirming a diagnosis, and they reported a high level of satisfaction with the evaluation, including strong agreement with diagnosis and recommendations. These findings did not differ based on physician specialty or patient diagnosis.

Attitude of Health Personnel↗