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Biomedical subjects

M Storandt

Publications and source records attributed to M Storandt.

At least 37 records · Page 2Linked to original sources

Sex differences in the sensitivity of two self-report depression scales in older depressed inpatients.

Both the Geriatric Depression Scale (J. A. Yesavage et al., 1983) and the Beck Depression Inventory (A. T. Beck, A. J. Rush, B. F. Shaw, & G. Emery, 1979) were less effective in identifying depressed men than women in a sample of 191 geriatric psychiatric inpatients with major unipolar depression. From one quarter to one half of the men were missed cases, depending on the cutoff score used. Separate cutoff scores for older men and women on depression screening instruments may be appropriate.

Aged↗

On the preservation of syntax in Alzheimer's disease. Evidence from written sentences.

We examined the syntactic complexity of single written sentences elicited from 368 adults undergoing examination for possible Alzheimer's disease. The clause length and composition of the sentences varied with the severity of dementia. The nondemented adults' sentences contained more propositions, main and secondary verbs, and conjunctions than those produced by the mildly and moderately demented adults. Sentence length in clauses, propositional content, and the use of conjunctions and main and secondary verbs discriminated among stages of the severity of the disease. The present results suggest that, while dementia severity affects written linguistic output, such output is, nonetheless, grammatic and coherent.

Aged↗

Influence of age on clinical and psychometric assessment of subjects with very mild or mild dementia of the Alzheimer type.

OBJECTIVE: The influence of age on performance on clinical and psychometric assessments is examined in groups of nondemented persons and individuals with either very mild or mild dementia of the Alzheimer type (DAT). DESIGN: Initial clinical and psychometric assessments of persons enrolled in longitudinal studies of DAT and nondemented control subjects. SETTING: Alzheimer's Disease Research Center at Washington University, St Louis, Mo. PARTICIPANTS: Volunteer samples of 108 people (44 men, 64 women) with mild DAT, 61 people (30 men, 31 women) with very mild DAT, and 122 healthy nondemented people (45 men, 77 women) were recruited between 1979 and 1991. Age ranged from 54 to 87 years. Persons with confounding medical, neurologic, or psychiatric disorders were excluded. Dementia severity was staged using the Clinical Dementia Rating scale. MAIN OUTCOME MEASURES: Five brief quantitative clinical tests included in the 90-minute clinician administered protocol, as well as 14 tests included in a 2-hour psychometric test battery. RESULTS: Dementia severity affected performance on all measurements. Age did not influence performance on clinical assessments. There was a significant interaction between age and dementia severity on 10 of 14 psychometric measures. In general, older nondemented individuals performed less well than younger nondemented individuals while older mildly demented persons performed about the same as, or slightly better than, their younger counterparts. CONCLUSIONS: Age does not affect performance on brief clinical assessment instruments. However, age affects psychometric performance differently in cognitively intact persons when compared with persons with DAT. As a result, psychometric differentiation between cognitively normal and demented individuals is more difficult in older populations.

Aged↗

The impact of long-term exercise training on psychological function in older adults.

The effect of long-term aerobic training on psychological function was examined in 87 sedentary older adults who engaged in a year-long endurance exercise training program compared with a nonexercising control group. In addition to improved cardiovascular fitness, a positive change in self-reported morale was found for the exercise condition. Of the cognitive functions measured, a significant effect was noted for the Wechsler Memory Scale (WMS) Logical Memory subtest; however, this effect was caused by a decline in performance from pre- to posttesting in the control group. Long-term exercise training had little, if any, effect on improving cognitive function in this older adult sample.

Affect↗

Immediate and delayed prose recall among normal and demented adults.

The Logical Memory subtest of the Wechsler Memory Scale (Form I) was administered as part of a battery of tests to 64 subjects without dementia and 51 with very mild dementia. The demented group's immediate and delayed recall was significantly impaired relative to the control group. Immediate and delayed scores were highly correlated in both groups. Hierarchical multiple-regression analyses revealed that dementia classification did not significantly predict delayed recall performance above and beyond immediate recall performance. This suggests that, in its early stages, dementia primarily affects the encoding of prose material.

Aged↗

Psychometric discrimination of moderate senile dementia of the Alzheimer type.

A brief psychometric battery was used to differentiate a sample of 56 individuals classified as having mild senile dementia of the Alzheimer type (SDAT) from 38 individuals with moderate SDAT. Using discriminant analysis techniques, a modest differentiation was obtained. It was noted that specific ability domains, namely, short-term recognition memory, visuospatial reasoning, and verbal ability, contributed to the discriminant function. Although the same domains have been found to differentiate SDAT at earlier stages, individual tests varied in the current sample as a function of marked decrements in ability levels at this advanced stage of the disease. The results suggest that the effectiveness of specific psychometrics for differentiating individuals with SDAT may vary as a function of relative disease stage.

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Agraphia in dementia of the Alzheimer type.

This study describes graphic errors made in writing a simple sentence in 368 healthy older adults and individuals in different stages of dementia of the Alzheimer type. Errors of agraphia were present in both healthy and demented people and, in general, increased with the severity of dementia. The errors of agraphia were not correlated with measures of aphasia or psychometric measures of language and motor performance. Writing skill may represent procedural memory, and agraphia errors indicate alterations in long-term memory in dementia of the Alzheimer type.

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Factorial structure of two health belief measures among older adults.

Confirmatory factor analysis of Wallston's Multidimensional Health Locus of Control Scale and Krantz's Health Opinion Survey was conducted using 197 nondiabetic and 171 diabetic older adults. Qualified support was found for the 3-factor structure of the Wallston measure when applied to older adults. The Krantz model provided a less-than-adequate representation of the older sample's data. When the items from these 2 measures were combined, a 4-factor structure was found. Multisample simultaneous factor analyses using LISREL revealed that the factor structures of the Wallston and the Krantz measures fit the diabetic and the nondiabetic samples fairly equivalently. Despite the similarities in factor structures, diabetic individuals reported greater belief in powerful others and less desire for behavioral involvement in the health-care process than did nondiabetics.

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Paired associate learning in senile dementia of the Alzheimer type.

A study was conducted to examine the potential explicit learning ability in senile dementia of the Alzheimer type (SDAT) as a function of (1) the difficulty of the to-be-remembered material and (2) the severity of the dementia. The Associate Learning task from the Wechsler Memory Scale was administered to healthy older adults and individuals with questionable, mild, and moderate SDAT. Individuals with SDAT showed poorer learning performance across trials than healthy older adults. Individuals with questionable and mild SDAT did show evidence for learning across trials for highly related paired associates. For unrelated-paired associates, however, only individuals with questionable SDAT showed some evidence for increased learning across trials.

Alzheimer Disease↗

The influence of major depression on clinical and psychometric assessment of senile dementia of the Alzheimer type.

OBJECTIVE: The performance on standard clinical and psychometric assessments of eight elderly individuals with major unipolar depression alone and seven with depression plus mild senile dementia of the Alzheimer type was compared with that of 41 nondepressed subjects suffering from very mild senile dementia of the Alzheimer type, 66 with mild senile dementia of the Alzheimer type, and 83 age-matched subjects without senile dementia. METHOD: Subjects with depression alone, depression plus mild senile dementia of the Alzheimer type, and very mild and mild senile dementia of the Alzheimer type met strict inclusionary and exclusionary criteria. A 90-minute semistructured interview, including several brief standardized clinical scales, was used to assign a Clinical Dementia Rating to each subject according to published guidelines, and each subject was given a 2-hour psychometric test battery. Data were analyzed by one-way multivariate analysis of variance to ascertain if there was an effect of group on clinical and psychometric test scores. RESULTS: The eight depressed subjects without concurrent dementia performed as well as the 83 nondepressed subjects without dementia on most clinical measures; however, their performance on most psychometric measures closely resembled that of the 41 nondepressed subjects with very mild dementia. The performance of the seven subjects with depression plus mild dementia was comparable to that of the 66 nondepressed subjects with mild dementia on most clinical and psychometric measures. CONCLUSIONS: Although depressed subjects performed as well as subjects without dementia on many clinical assessments, psychometric testing was not able to distinguish depressed subjects from those with very mild senile dementia of the Alzheimer type. This demonstrates the need for careful psychiatric evaluation before interpreting deficits on psychometric tests as indicating the presence of very mild senile dementia of the Alzheimer type.

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Very mild Alzheimer's disease: informant-based clinical, psychometric, and pathologic distinction from normal aging.

We compare clinicopathologic data from 10 subjects identified in the very mild stage of senile dementia of the Alzheimer type with findings from similar studies in four cognitively normal subjects. We based the diagnosis of very mild dementia in the 10 subjects on informant reports and the judgment of experienced clinicians. Deficits of some psychometric measures of memory, language, and speeded psychomotor performance were observed for these subjects. The histologic markers of Alzheimer's disease, including neurofibrillary tangles and both the "diffuse" and classic subtypes of senile plaques, were present in the neocortex in all 10 subjects but essentially were absent in the four controls. These findings indicate that even "questionable" dementia can be diagnostic for Alzheimer's disease. Furthermore, because truly normal aging may be unaccompanied by neocortical senile plaques and neurofibrillary tangles, the presence of these lesions should suggest the possibility of clinically undetected Alzheimer's disease.

Activities of Daily Living↗

Memory-skills training for older adults.

It is clear from this series of studies that older people can be taught to use some mnemonic strategies to enhance encoding of new information into memory. The effects of such training, however, may be difficult to maintain. Further, some mnemonic strategies appear to be more effective for older people than others. Categorizing works well as a way to improve list recall. Older people spend more time encoding the material, presumably because the elaborative process involved in the categorizing technique takes more time, and this pays off when the list is recalled. On the other hand, interactive images do not seem very useful in aiding the recall of names and faces. Perhaps recall of names and faces is inherently a difficult task or one that is especially susceptible to age-related memory changes. There may be better strategies to assist recall of names and faces than interactive images, especially for older adults. Given the success with the categorizing technique, perhaps more attention should be paid to verbal strategies rather than imaging. Because remembering people's names is such a prominent everyday memory problem, a great deal more attention should be paid to the search for effective memory skills that can be applied to this task. Most of the research on memory training has focused on skills that can be applied at encoding--when the information is first encountered. This has been a reasonable approach; the strength of a memory most certainly depends on how well the information is learned. At the same time, greater attention should be paid to memory skills that can be applied at retrieval. In many instances there is the need to recall information that was learned incidentally or to which encoding strategies were not applied. A first attempt to develop such a retrieval skills training program was not clearly effective (Heller, 1989). Perhaps the retrieval strategies were inadequate; perhaps people did not use them. Older people appear to have untapped retrieval skills that can be brought to bear if they are sufficiently motivated. If this is the case, it should be possible to devise retrieval strategies that can be taught and used more routinely. Neither training in encoding nor training in retrieval strategies seemed to assist recall of brief prose passages. Again because of the importance of this type of memory to everyday life (e.g., remembering a conversation), a great deal more attention should be paid to uncovering the important components of such memory and to ways it can be enhanced.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

Mild senile dementia of the Alzheimer type: 3. Longitudinal and cross-sectional assessment.

Sixty-six subjects diagnosed by validated criteria as having senile dementia of the Alzheimer type (SDAT) were assessed with clinical measures commonly used to study dementia. The severity of the SDAT was mild in 24, moderate in 24, and severe in 18. The data from these three groups in a cross-sectional study were compared with results in our earlier study of 43 subjects enrolled with mild SDAT and followed longitudinally. We concluded that the cross-sectional method underestimates the severity of progression as indicated by some of the clinical measures. Additionally, the 24 new subjects with mild SDAT were assessed longitudinally. This replication study confirmed our earlier conclusions that four of six clinical measures showed similar patterns over time and were useful throughout the study, global measures being more informative than brief individual measures with ceiling or floor effects.

Aged↗

Replication of a study of frequency analysis of the resting awake EEG in mild probable Alzheimer's disease.

In the resting EEG, the percentage power in the delta, theta, alpha, and beta bands and the mean frequency were computed in an occipital-vertex derivation for two samples of subjects. The original sample (n = 79) and the new sample (n = 43) each contained a mild probable Alzheimer's disease (SDAT) group and a healthy elderly control group. Group medians in both samples were higher in the SDAT than in the healthy subjects for percentage delta and theta, and were lower for percentage alpha and beta and for mean frequency. Percentage theta and mean frequency were consistent across the two samples in showing statistically significant differences between SDAT and healthy groups. The ability of each EEG measure to detect individual subjects with SDAT was assessed. The most effective measure, percentage theta, had only modest sensitivity (about 20%), but this was attained at a specificity of 100%. The accurate detection of an individual at the mild stage requires that the predictive value of a positive test be high to avoid misclassification of non-SDAT subjects as SDAT. This, in turn, requires a specificity of virtually 100% when the prevalence is low. The low sensitivity puts several constraints on the usefulness of the EEG. For this reason, when the dementia is at the mild stage the EEG would be a useful detector of probable Alzheimer's disease only under certain limiting conditions, including high prevalence, high specificity, and a willingness to accept a high rate of falsely negative tests.

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Supplemental group discussions in memory training for older adults.

Memory training was compared in adults aged 60-80. Groups 1 and 2 studied a self-instructional memory training manual; Group 2 also attended supplementary group discussions of typical problems of later life, related coping methods, and the techniques in the self-instructional manuals. Group 3 was a wait-list control group. Memory performance on 2 word lists significantly improved in the supplemental discussion group but not in the group that only studied the self-instructional manual. Enhanced performances were maintained at a 1-month follow-up. Bibliotherapy alone may be inferior to treatment involving a group component, although the mechanisms of such enhancement remain unexplored with respect to memory training. Neither treated group improved their digit span or recall of names and a brief prose passage; teaching older adults the strategies of chunking and use of imagery may not be beneficial.

Aged↗

Bender-Gestalt Test performance in senile dementia of the Alzheimer type.

Bender-Gestalt Test performances of 144 persons with very mild, mild, or moderate senile dementia of the Alzheimer type (SDAT) and 96 healthy older adults ranging in age from 63 to 95 were compared. Total scores and error types according to the modified Hutt-Briskin scoring system are reported. The Bender-Gestalt Test does not appear to be useful in differentiating very mild or mild SDAT from normal aging.

Age Factors↗

The effects of memory skills training and incentives on free recall in older learners.

The impact of memory skills training and external reward on free recall of serial word lists was assessed in 60 elderly community-dwelling adults. Participants were divided into four groups: (a) skills training plus incentive, (b) skills training only, (c) placebo plus incentive, and (d) placebo without incentive. The memory skills training involved 2 hours of class instruction and a take-home manual. The incentive was introduced following the posttest study interval, prior to recall, and was in the form of a lottery. The three experimental groups (skills only, skills plus incentive, and incentive only) recalled more words at the posttest interval than the placebo group. Skills training was associated with the greatest number of words recalled, followed by the incentive. No additional performance gains were found when skills training was coupled with incentive. A significant relationship between study time and word recall performance was found at posttest. Those who received skills training used more study time than did the no skills groups. The results suggest that teaching an active memory skill enhances free recall performance. Additionally, incentives were superior to no training. Combining incentives with skills, however, does not extend memory performance over skills training alone.

Aging↗