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Prediction of Outcome in Senile Dementia—A Computed Tomography Study

Published online by Cambridge University Press:  29 January 2018

Mohsen Naguib  and
Raymond Levy
Mohsen Naguib
Affiliation:
The Bethlem Royal and Maudsley Hospitals and the Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 6AF
Raymond Levy
Affiliation:
The Bethlem Royal and Maudsley Hospitals and the Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 6AF
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Summary

Forty patients suffering from senile dementia who had been subjected to detailed clinical and psychological assessment and computed tomography (CT) were followed up for a mean period of 28.78 months. All but one were traced. The deceased (27) were compared with the survivors (12). All males had died at follow-up. The mean age was not statistically significant but the survivors differed significantly from the deceased in having performed better on a number of clinical and psychological tests, particularly those involving speech functions and constructoinal ability. Measures of ventricular size and cortical atrophy were not of predictive value, but a new technique of measuring radiological density showed that this was significantly lower in the right parietal region in the original CT scans of those who subsequently died. The study confirms that clinical involvement of the parietal lobes is an indication of poor prognosis and reports the first radiological support for this view. It also suggests that a more directly quantitative approach to computed tomography may yield results which are more useful than those obtained from visual reconstructions.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 140 , Issue 3 , March 1982 , pp. 263 - 267
Copyright
Copyright © Royal College of Psychiatrists, 1982 

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References

Bank, L. & Jarvik, L. (1978) A longitudinal study of aging human twins. In The Genetics of Aging (ed. Schneider, Edward L.). New York: Plenum Press.Google Scholar
Bondareff, W. & Levy, R. (1981) Quantitative computed tomography in senile dementia. Archives of General Psychiatry, (in press).Google Scholar
Constantinides, J. (1978) Is Alzheimer's Disease a major form of senile dementia? Clinical, anatomical and genetic data. In Alzheimer's Disease: Senile Dementia and Related Disorders (eds. Katzman, R., Terry, R. D. and Bick, K. L.). New York: Raven Press.Google Scholar
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., Gourlay, A. J., Gurland, B. J., Fleiss, J. L. & Sharpe, L. (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: The Geriatric Mental State Schedule: 1. Development and reality. Psychological Medicine, 6, 439–49.CrossRefGoogle Scholar
Corsellis, J. A. N. (1962) Mental Illness and the Ageing Brain. Maudsley Monograph, No 9. London.Google Scholar
Glosser, G., Butters, N. & Kaplan, E. (1977) Visuoperceptual processes in brain damaged patients on the Digit Symbol Substitution Test British Journal of Neuroscience, 7, 59–66.Google Scholar
Go, R. C. P., Todorov, A. B., Elston, R. C. & Constantinides, J. (1978) The malignancy of dementias. Annals of Neurology, 3, 559–61.Google Scholar
Hare, M. (1978) Clinical checklist for diagnosis of dementia. British Medical Journal, ii, 266–7.Google Scholar
Hodkinson, H. M. (1973) Mental impairment in the elderly. Journal of the Royal College of Physicians of London, 7, 305–17.Google Scholar
Jacoby, R. & Levy, R. (1980) Computed tomography in the elderly: 2. Senile dementia: Diagnosis and functional impairment. British Journal of Psychiatry, 136, 256–69.Google Scholar
Jacoby, R., Levy, R. & Bird, J. (1981) Computed tomography and the outcome of affective disorder: A follow-up study of elderly patients. British Journal of Psychiatry, 139, 288–92.Google Scholar
Jarvik, L. F. & Blum, J. E. (1971) Cognitive decline as predictors of mortality in twin pairs: A twenty-year longitudinal study of ageing. In Prediction of Life Span (eds. Palmore, E. and Jeffers, F. C.). Lexington: D.C. Heath.Google Scholar
Kay, D. W. K. (1962) Outcome and cause of death in mental disorders of old age: A long-term follow-up of functional and organic psychoses. Acta Psychiatrica Scandinavica, 38, 249–76.Google Scholar
Kendrick, D. C. (1965) Speed and learning in the diagnosis of diffuse brain damage in elderly subjects: A Bayesian statistical approach. British Journal of Social and Clinical Psychology, 4, 141–8.Google Scholar
McDonald, C. (1969) Clinical heterogeneity in senile dementia. British Journal of Psychiatry, 115, 267–71.Google Scholar
Naeser, M. A., Gebhardt, C. & Levine, H. L. (1980) Decreased computed tomography numbers in patients with presenile dementia. Archives of Neurology, 37, 401–9.Google Scholar
Naeser, M. A., Albert, M. S. & Kleefield, J. (1981) New methods in the CT scan diagnosis of Alzheimer's Disease: Examination of white and grey matter mean CT density numbers. Archives of Neurology, (in press).Google Scholar
Roth, M. (1955) The natural history of mental disorder in old age. Journal of Mental Science, 101, 281–301.Google Scholar
Roth, M., Tomlinson, B. E. & Blessed, G. (1966) Correlation between scores for dementia and counts of ‘senile plaques’ in cerebral grey matter of elderly subjects. Nature, 209, 109–10.Google Scholar
Shah, K. U., Banks, G. D. & Merskey, H. (1969) Survival in arteriosclerotic and senile dementia. British Journal of Psychiatry, 115, 1283–6.Google Scholar
Thompson, E. G. & Eastwood, M. R. (1981) Survivorship and senile dementia. Age and Ageing, 10, 29–32.Google Scholar
Wechsler, D. (1955) The Wechsler Manual. New York: The Psychological Co-Operation.Google Scholar
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