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Biomedical subjects

J M Starr

Publications and source records attributed to J M Starr.

64 records · Page 4Linked to original sources
PubMed1992

Senile hypertension and cognitive impairment: an overview.

PURPOSE: Both hypertension and cognitive impairment are common disorders in old people. This paper reviews epidemiological, clinical and experimental studies that have examined the association between these conditions. CONTENTS: Evidence is presented which suggests that raised blood pressure levels contribute to cognitive impairment in susceptible people, particularly those with concomitant conditions which predispose them to cerebral ischemia. Some studies have demonstrated that certain classes of antihypertensive drugs may have beneficial actions on ischaemic and cell growth processes, while others may tend to impair cognitive function, either by central actions or by alterations to cerebral blood flow. CONCLUSIONS: A successful approach to the treatment of hypertension-associated cognitive impairment is likely to follow a detailed analysis of risk factors in the individual patient. Fundamental epidemiological work is required to clarify genetic components or risk, and more long-term treatment trials would also be helpful, although these have proved problematic in the elderly. At present, although it is clear that old people with hypertension should be treated, whether or not they are also cognitively impaired, further studies are necessary to decide on the best antihypertensive therapy for this substantial population.

Aged↗
PubMed1990

Continuous, in vivo pulmonary venous admixture from fiberoptically measured hemoglobin saturations.

In six anesthetized swine, pulmonary venous admixture (Qsp/Qt) was calculated by four methods: a) Qsp/Qt 1, fiberoptically measured arterial and mixed venous Hgb saturation (SaO2 and SvO2), PaO2 and PvO2 derived from saturations; b) Qsp/Qt 2, fiberoptically measured SaO2 and SvO2, PaO2 and PvO2 measured by blood gas analysis; c) Qsp/Qt 3, PaO2 and PvO2 measured by blood gas analysis, SaO2 and SvO2 derived from tensions; d) Qsp/Qt 4, SaO2 and SvO2 measured by bench oximetry, PaO2 and PvO2 derived from saturations. Input from the fiberoptic catheters was fed into a computer programmed to calculate Qsp/Qt 1 every 20 sec. Fifty-eight of these values were compared with simultaneously calculated Qsp/Qt 2, 3, and 4. There was no difference between fiberoptic and derived SaO2 or fiberoptic and cooximetric SvO2. Correlations and slopes for Qsp/Qt 1 with Qsp/Qt 2, 3, and 4 were significant (p less than .05). Comparing mean differences, Qsp/Qt 1 was significantly different only from Qsp/Qt 3 (p less than .01). We conclude that dual oximetry reliably tracks Qsp/Qt.

Animals↗
PubMedDate not supplied

Assessment and treatment of dementia in medical patients.

The incidence of dementia rises rapidly with age. Elderly people commonly have significant medical conditions that impact on cognition and functional ability. The diagnosis of dementia requires both a decline in cognition and loss of functional ability. Assessment of dementia in medical patients requires a holistic approach that encompasses the spectrum of disease from measuring impairment of specific mental abilities to evaluating handicap in the patient's normal social setting. Similarly, treatment can be aimed at any point in this spectrum. Recent licensing of new cholinesterase inhibitors for the treatment of Alzheimer's disease has introduced specific problems in the treatment of medical patients with dementia. This review provides a framework for clinicians to assess and treat dementia in medical patients and describe s a practical approach to the prescribing of cholinesterase inhibitors in patients with concomitant medical problems.

Aged↗
PubMedDate not supplied

Correlates of informant-rated cognitive decline after stroke.

Cognitive impairment is common after stroke, but measurement is problematic. Six tests of mental ability, unaffected by loss of limb function, were administered to 49 subjects of mean age 74.2 years at a median of 4.3 years (range 0.1-16.8) after stroke together with a depression score and the IQCODE, an informant-rated scale of estimated cognitive decline. Over 90% of stroke patients were able to complete most tests. IQCODE correlated significantly with the HADS depression score (r = 0.35, p = 0.040), the 2-year Barthel score (r = -0.60, p = 0.001) and with a general cognitive factor extracted from the mental ability test scores (r = -0.42, p = 0.016). We conclude that informant-rated methods offer a promising approach to measuring cognitive decline after stroke.

Activities of Daily Living↗
PubMedDate not supplied

Toward a social phenomenology of aging: studying the self process in biographical work.

In recent years, the study of aging has come to be increasingly multidisciplinary and to encompass the whole life course. The well established life history approach has been reformulated to include the macro-structural and cultural context of aging. Over the past decade research on adult development and aging, cohort differences in aging patterns, and historical changes in life course differentiation has challenged the validity of the established "stability" and "ordered change" theories of aging. An "aleatoric" account of aging, which calls attention to the flexibility of developmental patterns, has been proposed in their stead. Consistent with this development is the need to replace the old conception of the self as a passive object of outside social forces with a new conception of the self as an active, self-reflexive agent in society. The author demonstrates the utility of certain core concepts in social phenomenology and ethnomethodology, in particular Schutz's concept of biographical work, for developing this new conception of the self. It is proposed that more attention to the practical procedures of reality construction involved in biographical work would provide the epistemological basis and conceptual clarity needed for empirical research on the dynamics of life histories.

Aging↗