ABSTRACT
Authors have studied the psychopathological structure, risk factors and predictors of mental confusion in 102 patients with dementia of different etiologies (Alzheimer's disease (AD), cerebrovascular dementia (CVD) and mixed Alzheimer disease/vascular dementia). The high frequency (>40%) of mental confusion in patients with dementia admitted to geriatric departments of a psychiatric hospital has been identified. Mental confusion was most frequently characterized by a syndrome of memory and/or confabulatory confusion. The causes of mental confusion in elderly patients with dementia, including the exacerbation of a somatic pathology and changes in conditions of patient's staying in hospital, have been specified. The frequency of mental confusion is correlated with patient's age: more than 55% of cases has been noted in the group aged over 70 years. Mental confusion develops 6 times more frequent in patients with moderately severe and severe dementia than in those with mild dementia. Timely diagnosis and adequate treatment are predictors of favorable outcome in most patients. Treatment of this syndrome should be strictly differential. Antipsychotic treatment is needed in case of persistent psychotic symptoms and severe behavioral disturbances. Drugs for pathogenetic therapy of dementia have been used in the complex treatment of mental confusion in patients with dementia, in particular AD.
Subject(s)
Antipsychotic Agents/therapeutic use , Confusion/etiology , Dementia/complications , Geriatric Assessment/methods , Age Factors , Aged , Aged, 80 and over , Confusion/drug therapy , Confusion/epidemiology , Dementia/drug therapy , Dementia/psychology , Female , Follow-Up Studies , Humans , Male , Prevalence , Prognosis , Quality of Life , Russia/epidemiologyABSTRACT
Twenty-five patients with Alzheimer's disease (AD) in moderate-severe and severe stages received galantamine in dosage 8 mg daily during the 1st month with the following increasing to 16 mg daily. Six patients received 24 mg per day from the 3rd month. The total duration of therapy was 26 weeks. 15 patients received in addition the antipsychotic therapy. Reminyl had a positive effect on cognitive functions and psychotic symptoms of dementia, in particular delusions, aggression and irritability, apathy, aberrant motor behavior, eating and sleep disorders. The therapeutic reduction of these disorders resulted in the distinct reduction of physical and mental burden on the caregivers. The therapeutic effects of reminyl and its good tolerability allow to recommend this drug for treatment of severe stages of AD.
Subject(s)
Alzheimer Disease/drug therapy , Cholinesterase Inhibitors/therapeutic use , Cognition/drug effects , Galantamine/therapeutic use , Aged , Aged, 80 and over , Alzheimer Disease/diagnosis , Cholinesterase Inhibitors/administration & dosage , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Galantamine/administration & dosage , Humans , Male , Middle Aged , Severity of Illness Index , Treatment OutcomeABSTRACT
Quantitative EEG was used to reveal the specific features of its amplitude-frequency parameters and topography in patients with mild dementia of different genesis versus healthy elderly individuals. All four study groups of patients differ in EEC relative spectral density, they also differ from the healthy persons while alpharhythm was suppressed in Alzheimer's disease (AD) and vascular dementia (VD) and there was slower alpha-rhythm and higher theta-activity in senile AD (SAD). Patients with VD were characterized by desynchronized EEG. Factorial and stepwise discriminant analyses of EEG parameters showed that the control group greatly differed from patients with mild dementias. Patient groups mainly with atrophic atrophic AD and SAD or vascular (VD and mixed) dementia were also different whereas the mixed vascular-atrophic group is intermediate in EEC parameters between the VD group and the partially overlapped AD and SDA patient groups. Quantitative EEC data may be thus used for differential diagnosis to optimize therapy and prognosis even in mild dementia.
Subject(s)
Brain/pathology , Dementia/diagnosis , Dementia/etiology , Electroencephalography , Aged , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Prognosis , Severity of Illness IndexABSTRACT
Brain computed tomographic scans of 43 patients with Alzheimer's disease (moderate and severe dementia) were compared to those of age-matched normal subjects (30 controls). Computed tomographic analysis included some linear and volume ventricular measurements. These indices correlated with relevant psychopathological and psychometric findings. Linear measurements of the ventricular size and the degree of cortical, central atrophy were significantly greater in patients with Alzheimer's disease than in the control group. In line with the disease progression and its development from moderate to severe dementia the degree of brain structural changes increased with the predominance of cortical atrophy in parietal lobes and central atrophy in mediobasal parts of the temporal lobes.
