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Biomedical subjects

R Eastwood

Publications and source records attributed to R Eastwood.

At least 19 recordsLinked to original sources
PubMed1997

Prevalence and severity of cognitive impairment with and without dementia in an elderly population.

BACKGROUND: Not all cognitively impaired people have dementia, but those who do not meet current criteria for dementia have received little study. We report a comprehensive estimate of the prevalence of "cognitive impairment, no dementia" (CIND) in an elderly population. METHODS: The Canadian Study of Health and Aging gathered population representation information about elderly Canadians aged 65 and over from 36 cities and surrounding areas in five regions. In each region, the sample size was 1800 people in the community and 250 people in institutions. Patients in the community were screened for cognitive impairment by means of the modified mini-mental state examination. Those who scored below the cut-off point (n = 1106) and a randomly selected sample of those who scored above the cut-off point (n = 494) were referred for clinical examination. 59 individuals unable to take the screening test were also assessed clinically. We selected 17 long-term care institutions in each region, and then randomly selected consenting residents of these institutions for clinical assessment (n = 1255). RESULTS: The prevalence of CIND was 16.8%, which was more than all types of dementia combined (8.0%). The prevalence of all types of cognitive impairment, including dementias, increased with age. Patients with CIND were three times more likely to be living in institutions than were cognitively unimpaired patients (odds ratio 3-1 [95% CI 2.4-3.9]). Circumscribed memory loss has a prevalence of 5.3% in the elderly Canadian population, and was the most common category. CIND was related to some degree of functional impairment in elderly patients. INTERPRETATION: CIND is commonly associated with functional disability and a need for institutional care. This diagnostic category includes a costly group of disorders that merit further study.

Aged↗
PubMed1997

Dementia: current developments.

This is a short review of the current developments taking place in the field of the dementias. This branch of medicine is growing apace with fresh research findings being published continually in respect to etiology, risk and protective factors, clinical typology and treatment effects. At the same time we know remarkably little about the natural history of cognitive decline and in effect, normal aging. There is clearly a vital need for longitudinal studies. Also, new hypotheses are needed to explain the critical memory defect in dementia. In fact, better treatment of the memory defect, and the associated behavioral problems found in dementia is urgently needed and even demended by an increasingly more sophisticated public.

Dementia↗
PubMed1997

Diagnosis of Alzheimer's disease. Report of an International Psychogeriatric Association Special Meeting Work Group under the cosponsorship of Alzheimer's Disease International, the European Federation of Neurological Societies, the World Health Organization, and the World Psychiatric Association.

Current knowledge with respect to the diagnosis of Alzheimer's disease (AD) is reviewed. There is agreement that AD is a characteristic clinicopathologic entity that is amenable to diagnosis. The diagnosis of AD should no longer be considered one of exclusion. Rather, the diagnostic process is one of recognition of the characteristic features of AD and of conditions that can have an impact on presentation or mimic aspects of the clinicopathologic picture. The present availability of improved prognosis, management, and treatment strategies makes the proper, and state-of-the-art, diagnosis of AD a clinical imperative in all medical settings. Concurrently, information regarding the relevance and applicability of current diagnostic procedures in diverse cultural settings must continue to accrue.

Aged↗
PubMed1996

The kinetics of skin thinning induced by topical fluticasone propionate 0.05% cream in volunteer subjects.

Fluticasone propionate (FP) 0.05% (CutivateTM) cream is a novel corticosteroid used for the treatment of corticosteroid-responsive dermatoses. To date there are no published data concerning its effect on cutaneous atrophy. This randomized, double-blind study of 40 volunteer subjects was performed to investigate the kinetics of skin thinning induced by topical 0.05% FP cream vs. placebo after once-daily application for 2-8 weeks. The results of this study showed no significant effect on the skin thickness of subjects after 8 weeks' treatment with 0.05% FP cream compared with placebo.

Administration, Cutaneous↗
PubMed1996

Standardization of the diagnosis of dementia in the Canadian Study of Health and Aging.

Standardization of diagnostic procedures for cognitive impairment in large epidemiologic surveys remains difficult. This paper reports results of diagnostic standardization in a subsample of 2,914 elderly (age 65 years+) Canadians from the Canadian Study of Health and Aging (CSHA; n = 10,263). The objectives were to measure the consistency of the CSHA diagnosis as a test of validity; to assess inter-rater reliability, and to assess the impact of neuropsychological data on the diagnosis of dementia. The CSHA clinical assessment included a nurse's examination, Modified Mini-Mental Status (3MS) exam and Cambridge Mental Disorders Examination, neuropsychological tests, medical history and examination, and laboratory investigations. A final diagnosis was reached in a consensus conference which incorporated preliminary diagnoses from both physicians and neuropsychologists. Computer algorithms, which were developed to check consistency between the clinical observations and the final diagnosis, demonstrated 98% concordance with DSM-III-R criteria for dementia and 92% with NINCDS-ADRADA (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association) criteria for probable Alzheimer's disease. Inter-rater agreement was high: kappa = 0.81 for dementia/no dementia; kappa = 0.74 for normal/cognitive impairment, not dementia/ dementia. Comparisons of diagnoses between raters by clinical specialty revealed few systematic differences. The impact of neuropsychological input on the physician's diagnosis was most marked in the borderline cases between diagnostic categories.

Aged↗
PubMed1994

Couch fellows.

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Humans↗
PubMed1994

Adieu to Alzheimer?

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Alzheimer Disease↗
PubMed1993

Weeding out.

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Female↗
PubMed1993

The health and wellbeing of informal caregivers: a review and study program.

Informal caregivers are the families and other unpaid caregivers in the home who support people of all ages with severe and chronic mental or physical disabilities. Home care of this sort has been increasing over the past 30 years because of the reduced number of beds in hospitals and nursing homes and increased outpatient and community care. Moreover, with an aging population and increasing rates of disability, the demand for family caregiving will continue to rise. This has important implications for the development of health, community service and social policy. At the same time, however, very little is known about the impact such changes are having on the caregivers of various ages and in various circumstances. The Victorian Health Promotion Foundation is funding a research and intervention program in Melbourne to promote wellbeing and prevent ill-health in caregivers.

Caregivers↗
PubMed1989

Pseudodementia.

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Aged↗
PubMed1983

A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity.

Schizophrenic patients' self-reports of their experience of neuroleptic treatment were used as the basis for the construction of a scale predictive of drug compliance. Reliability analysis of the responses of 150 patients indicated high internal consistency in the 30-item scale, and preliminary validation in the form of discriminant classification accurately assigned 89% of the sample to complaint and non-compliant groupings. Both discriminant and factor analyses suggest that maximum variability in responding is accounted for by items reflecting how the patient feels on medication, rather than what he knows or believes about medication.

Adult↗
PubMed1982

Weather and infradian rhythms in self-reports of health, sleep and mood measures.

Some individuals exhibit significant and sustained periodicities in their self-reports of physical well-being, mood, hours of sleep, anxiety and cognition. These infradian rhythms may be related to weather variables such as solar flux, barometric pressure, temperature and humidity. The time of year, or season, during which self-reporting is performed may predicate the infradian rhythms and their relationship to weather.

Affect↗
PubMed1981

Estimates of the prevalence of bipolar affective disorder. Methods based on treatment with lithium.

During this century the epidemiology of the affective disorders has been studied, several classifications have been described and effective treatment measures have been introduced. Difficulties have been encountered in the epidemiology area due to inconsistent use of the terminology of measurement and varying types of classification; although it is possible to arrive at a broad consensus of agreement if the data are examined restrictedly. The clinical need for accurate rates of illness has become greater since the inception of the prophylactic drug lithium carbonate. While not used specifically for bipolar affective disorder, it is only for this disorder that its use has been demonstrated beyond doubt. The occurrence of mania in this disorder enables this aspect of the condition to be used as a marker. This paper describes three measures of the period prevalence of bipolar affective disorder, based upon treatment with lithium, two of which are of the "unobtrusive' type. Agreement was found between the three approaches and the utility of these for general use is discussed.

Bipolar Disorder↗