Personality changes in Alzheimer's disease.

We profiled personality changes that were measured cross-sectionally on the Blessed Dementia Scale in 80 patients with Alzheimer's disease who were examined at a dementia clinic. The most common personality changes were diminished initiative/growing apathy (61.3%), relinquishment of hobbies (55.0%), and increased rigidity (41.3%). The least frequent personality change was sexual misdemeanor (3.8%). Discriminant function analysis showed that the Global Deterioration Scale, the Clinical Rating Scale for Symptoms of Psychosis in Alzheimer's Disease, and the duration of dementia symptoms were the best predictors to classify personality change in an overall score of personality. However, cognitive impairment, as measured by the Blessed Memory-Information-Concentration Test and Mini-Mental State Examination, was not a good predictor of overall personality change. Personality and behavioral changes are common in Alzheimer's disease and may not be attributed entirely to intellectual impairment.

Alzheimer's disease. Clues to the cause.

Although Alzheimer's disease was described at the turn of the century, it has gained notoriety only in the past several decades. Interest in the disease has been catapulted forward by the dramatic increase in the number of elderly persons, the most rapidly expanding segment of the population. As the proportion of the aged population grows, so too will the medical and social consequences of the disease. Thus far, the most substantial leads in the search for a cause of Alzheimer's disease have been in the areas of genetic, biochemical, and epidemiologic research. While certain environmental factors such as aluminum have provoked interest, their role remains controversial.

Influence of feelings of burden on the caregiver's perception of the patient's functional status.

We studied the correlation between the caregiver's feelings of burden and the cognitive, behavioral and functional impairment of demented patients. We attempted to show the influence of caregiver's feelings of burden on their perception of the patients' functional status and to establish the predictors of feelings of burden. Twenty-five probable Alzheimer disease patients (NINCDS-ADRDA criteria) were assessed on cognitive measures and functional status (DAFS). The caregiver's index of burden (CIB), obtained from an adapted version of the Zarit Burden Interview, was correlated with the caregiver's report on the patient's instrumental activities of daily living (IADL) and physical self-maintenance functions (ADL); total and partial DAFS scores, and patient's cognitive and behavioral problems rated with the Functional Dementia Scale (FDS). The CIB correlated with the caregiver's report on the patient's behavioral disturbances (r = 0.71, p < 0.001) and physical self-maintenance activities (r = 0.62, p < 0.001), but not with cognitive impairment, IADL and the DAFS. The patients showed better functional performance in the direct assessment than in that reported by their caregivers (mainly in shopping, feeding, dressing, and ambulation). Thus, burden may foster a growing intolerance of the caregiver, inducing an underestimation of the patient's actual functional competence. The caregiver's report on the patient's behavioral problems was the best predictor of feelings of burden (P = 19,9, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Racial differences in the Hachinski ischemic score

Se describen las características de la Escala Isquémica de Hachinski en 29 pacientes afro-americanos y en 51 pacientes americanos de raza blanca. Los pacientes afro-americanos presentaron una mayor prevalencia de hipertensión arterial, así como valores más altos en la Escala Isquémica de Hachinski. Sin embargo, en el 93%(27-29) de los mismos la Escala de Hachinski mostró valores compatibles con el diagnóstico de una demencia degenerativa primaria. En una población racial mixta con una alta prevalencia de hipertensión arterial la Escala Isquémica de Hachinski clasificó correctamente a los pacientes afro-americanos con enfermedad de Alzheimer definida por los criterios del DSM III-R

Racial differences in the Hachinski ischemic score

Se describen las características de la Escala Isquémica de Hachinski en 29 pacientes afro-americanos y en 51 pacientes americanos de raza blanca. Los pacientes afro-americanos presentaron una mayor prevalencia de hipertensión arterial, así como valores más altos en la Escala Isquémica de Hachinski. Sin embargo, en el 93%(27-29) de los mismos la Escala de Hachinski mostró valores compatibles con el diagnóstico de una demencia degenerativa primaria. En una población racial mixta con una alta prevalencia de hipertensión arterial la Escala Isquémica de Hachinski clasificó correctamente a los pacientes afro-americanos con enfermedad de Alzheimer definida por los criterios del DSM III-R