Subject(s)
Alzheimer Disease/epidemiology , Neoplasms/epidemiology , Aged , Aged, 80 and over , Alzheimer Disease/complications , Autopsy , Female , Humans , Male , Neoplasms/complicationsSubject(s)
Dementia/drug therapy , Phenothiazines/therapeutic use , Aged , Geriatric Psychiatry , HumansABSTRACT
A study was made of 343 elderly mental-hospital patients whose mental disorder had begun late in life. Of the 31 brains examined at autopsy, 14 showed cerebral infarcts without senile brain disease and ten showed senile brain disease without infarcts. The amounts of arteriosclerosis in the two groups were compared. The microscopic evidence was not treated statistically, but the macroscopic evidence was subjected to Fisher's exact test and chi square for comparison of the amounts of arteriosclerosis noted at the base of the brain and the number of plaques on the named arteries within the brain. The results showed an overwhelming preponderance of arteriosclerosis in the infarct patients compared with the senile brain disease patients. It is concluded that in elderly patients with mental disorders, brain infarcts occur in close and causal relationship with cerebral arteriosclerosis. The bearing of this observation upon the concept of multi-infarct dementia is discussed.
Subject(s)
Cerebral Infarction/complications , Dementia/complications , Intracranial Arteriosclerosis/complications , Aged , Brain/pathology , Brain Diseases/complications , Brain Diseases/pathology , Cerebral Arteries/pathology , Cerebral Infarction/pathology , Dementia/pathology , Humans , Intracranial Arteriosclerosis/pathologyABSTRACT
The place of the medical director in the acute care general hospital is discussed. The federal legislation mandating medical directors for nursing homes is summarized, and is criticized for being too closely based on acute care general hospital models. Descriptive writing about the medical director's role are reviewed, and also quantified surveys. It is suggested that an educational and consultative role is most suitable. There is doubt about the ability of the medical director to control and supervise medical staff. His/her ability to control quality of care is also dubious.
Subject(s)
Nursing Homes/standards , Physician Executives , Quality of Health Care , Humans , Professional Review Organizations , Role , United StatesABSTRACT
Maudsley Tests of the Sensorium (used by clinicians to assess verbal memory and orientation) and Kendal's Memory for Design (used by psychologist to assess visual memory) were employed to differentiate between elderly patients with organic brain damage (neurologic disease, chiefly stroke) and those with functional psychiatric disorders which had been present in youth. There were 25 patients in each group. Both test differentiated organic from functional disorders. There was no statistically significant difference in the effectiveness of the two tests.
