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Early development and progression of dementing illness in the elderly: a general-practice based study

Published online by Cambridge University Press:  09 July 2009

B. Cooper ,
H. Bickel  and
M. Schäufele
B. Cooper*
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
H. Bickel
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
M. Schäufele
Affiliation:
Central Institute of Mental Health, Mannheim, Germany
*
1Address for correspondence: Dr Brian Cooper, Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

In a study carried out in 21 general practices in Mannheim, Germany, a stratified random sample (N = 507) of patients over the age of 65 years was drawn from the total of nearly 4000 who were medically documented. Eighty per cent of the sample were examined, using the Hierarchic Dementia Scale to test cognitive functioning and the CAMDEX criteria to assess global clinical severity. Repeat assessment after a mean interval of 27 months showed that all new cases of clinical dementia had arisen in persons with mild deficits initially and represented one-fifth of this group. The first-assessment ratings of cognitive function proved to be strongly predictive of risks for age-corrected mortality, admission to long-term care and dependency at follow-up, as well as of further progressive cognitive decline.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 2 , March 1996 , pp. 411 - 419
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Beardsall, L. & Huppert, F. A. (1991). A comparison of clinical psychometric and behavioural memory tests. Findings from a community study of the early detection of dementia. International Journal of Geriatric Psychiatry 6, 295–306.CrossRefGoogle Scholar
Bickel, H. (1992). Cognitive disorders and dementia among elderly general-practice patients in a West German city. In Primary Health Care and Psychiatric Epidemiology (ed. Cooper, B. and Eastwood, M. R.), (pp. 253–276) Routledge: London.Google Scholar
Blessed, C., Tomlinson, B. E. & Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter. British Journal of Psychiatry 114, 797–811.CrossRefGoogle ScholarPubMed
Burns, A., Jacoby, R. & Levy, R. (1991). Progression of cognitive impairment in Alzheimer's disease. Journal of the American Geriatrics Society 39, 39–45.CrossRefGoogle ScholarPubMed
Christensen, H., Hadzi-Pavlovic, D. & Jacomb, P. (1991). The psychometric differentiation of dementia from normal aging: a meta-analysis. Psychological Assessment 3, 147–155.CrossRefGoogle Scholar
Cole, M. & Dastoor, D. (1987). A new hierarchic approach to the measurement of dementia. Psychosomatics 28, 298–304.CrossRefGoogle Scholar
Cooper, B. & Bickel, H. (1984). Population screening and the early detection of dementing disorders in old age: a review. Psychological Medicine 14, 81–95.CrossRefGoogle ScholarPubMed
Cooper, B., Bickel, H. & Schäufele, M. (1992 a). The ability of general practitioners to detect dementia and cognitive impairment in their elderly patients: a study in Mannheim. International Journal of Geriatric Psychiatry 7, 591–598.CrossRefGoogle Scholar
Cooper, B., Bickel, H. & Schäufele, M. (1992 b). Demenzerkrankungen und leichtere kognitive Beeinträchtigung bei älteren Patienten in der ärztlichen Allgemeinpraxis. Ergebnisse einer Querschnittuntersuchung. (Dementia and milder cognitive impairment among elderly general-practice patients: findings of a survey.) Nervenarzt 63, 551–560.Google Scholar
Cox, D. R. (1972). Regression models and life tables. Journal of the Royal Statistical Society 34, 187–220.Google Scholar
Dastoor, D. & Cole, M. G. (1988). Age-related patterns of decline in dementia as measured by the Hierarchic Dementia Scale. American Journal of Alzheimer Care and Related Disorders 11./Dec. 1988, 29–35.CrossRefGoogle Scholar
Flicker, C., Ferris, S. H. & Reisberg, B. (1991). Mild cognitive impairment in the elderly: predictors of dementia. Neurology 41, 1006–1009.CrossRefGoogle ScholarPubMed
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. & Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry 140, 566–572.CrossRefGoogle ScholarPubMed
Kelman, H. R., Thomas, C., Kennedy, G. J. & Cheng, J. (1994). Cognitive impairment and mortality in older community residents. American Journal of Public Health 84, 1255–1260.CrossRefGoogle ScholarPubMed
Masur, D. M., Silwinski, M., Lipton, R. B., Blau, A. D. & Crystal, H. A. (1994). Neuropsychological prediction of dementia and the absence of dementia in healthy persons. Neurology 44, 1427–1432.CrossRefGoogle Scholar
Mowry, B. J. & Burvill, P. W. (1988). A study of mild dementia in the community using a wide range of diagnostic criteria. British Journal of Psychiatry 153, 328–334.CrossRefGoogle ScholarPubMed
O'Connor, D. W., Pollitt, P. A., Jones, B. J., Hyde, J. B., Fellowes, J. L. & Miller, N. D. (1991 a). Continued clinical validation of dementia diagnosed in the community using the Cambridge Mental Disorders of the Elderly Examination. Acta Psychiatrica Scandinavica 83, 41–45.CrossRefGoogle ScholarPubMed
O'Connor, D. W., Pollitt, P. A., Hyde, J. B., Fellowes, J. L., Miller, N. D. & Roth, M. (1991 b). The progression of mild idiopathic dementia in a community population. Journal of the American Geriatrics Society 39, 246–251.CrossRefGoogle Scholar
Petersen, R. C., Smith, G. E., Ivnik, R. J., Kokman, E. & Tangalos, E. G. (1994). Memory function in very early Alzheimer's disease. Neurology 44, 867–872.CrossRefGoogle ScholarPubMed
Pfeffer, R. I., Kurosaki, T. T., Chance, J. M., Filos, S. & Bates, D. (1984). Use of the mental function index in older adults: reliability, validity and measurement of change over time. American Journal of Epidemiology 120, 922–935.CrossRefGoogle ScholarPubMed
Reisberg, B., Ferris, S. H., de Leon, M. J. & Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry 139, 1136–1143.Google ScholarPubMed
Rönneberg, L. & Ericsson, K. (1994). Reliability and validity of the Hierarchic Dementia Scale. International Psychogeriatrics 6, 87–94.CrossRefGoogle Scholar
Roth, M., Huppert, F. A., Tym, E. & Mountjoy, C. Q. (1988). The Cambridge Examination for Mental Disorders of the Elderly. Cambridge University Press: Cambridge.Google Scholar
Sclan, S. G. & Reisberg, B. (1992). Functional assessment staging (FAST) in Alzheimer's disease: reliability, validity, and ordinality. International Psychogeriatrics 4 (Suppl. 1), 55–69.CrossRefGoogle ScholarPubMed
Storandt, M. & Hill, R. D. (1989). Very mild dementia of the Alzheimer type. Archives of Neurology 46, 383–386.CrossRefGoogle ScholarPubMed
Wechsler, D. (1987). Wechsler Memory Scale – Revised. Psychological Corporation: New York.Google Scholar
Welsh, K. A., Butters, N., Hughes, J. P., Mohs, R. C. & Heyman, A. (1992). Detection and staging of dementia in Alzheimer's disease. Use of the neuropsychological measures developed for the Consortium to Establish a Registry for Alzheimer's Disease. Archives of Neurology 49, 448–452.CrossRefGoogle ScholarPubMed
World Health Organization (1980). International Classification of Impairments, Disabilities and Handicaps (ICIDH). WHO: Geneva.Google Scholar