Journal of American Geriatrics Society

Pfeiffer, Eric

doi: 10.1111/j.1532-5415.1975.tb00927.xpmid: 1159263

ABSTRACT Clinicians whose practice includes elderly patients need a short, reliable instrument to detect the presence of intellectual impairment and to determine the degree. A 10‐item Short Portable Mental Status Questionnaire (SPMSQ), easily administered by any clinician in the office or in a hospital, has been designed, tested, standardized and validated. The standardization and validation procedure included administering the test to 997 elderly persons residing in the community, to 141 elderly persons referred for psychiatric and other health and social problems to a multipurpose clinic, and to 102 elderly persons living in institutions such as nursing homes, homes for the aged, or state mental hospitals. It was found that educational level and race had to be taken into account in scoring individual performance. On the basis of the large community population, standards of performance were established for: 1) intact mental functioning, 2) borderline or mild organic impairment, 3) definite but moderate organic impairment, and 4) severe organic impairment. In the 141 clinic patients, the SPMSQ scores were correlated with the clinical diagnoses. There was a high level of agreement between the clinical diagnosis of organic brain syndrome and the SPMSQ scores that indicated moderate or severe organic impairment.

Asmussen, Erling; Fruensgaard, Karen; Nørgaard, Steen

doi: 10.1111/j.1532-5415.1975.tb00928.xpmid: 1159264

ABSTRACT Reported is the continuation of follow‐up investigations of certain physiologic functions in former physical education students. The first follow‐up study was conducted about 30 years after the initial measurements. The present follow‐up study concerned a re‐investigation of the same group (23 men and 11 women), 10 years later, i.e., about 40 years after the first examination. Resting values for heart rate, blood pressure and metabolism were determined, as well as values for lung volume, hand‐grip strength, and reaction time. During moderately hard exercise, measurements were made of oxygen uptake, ventilatory equivalents, and heart rate. By extrapolation of these heart‐rate determinations to “maximal heart rate,” the maximal oxygen uptake was estimated and expressed as L × min−1 and as ml × kg−1 × min−1. The data show a general deterioration in practically all the physiologic functions studied, most pronounced during the last 10 years of the 40‐year period.

Salzman, Carl; Shader, Richard I.; Harmatz, Jerold; Robertson, Linda

doi: 10.1111/j.1532-5415.1975.tb00929.xpmid: 1159265

ABSTRACT Forty male volunteers over the age of 60 took either a daily dose of diazepam (12 mg) or placebo for a two‐week period. Differential responses to these compounds partially depended upon age and the initial symptom level. Diazepam produced sedative side effects, a modest antidepressant effect, and a reduction in memory. Placebo had an antianxiety effect in the relatively older subjects, and was associated with decreased fatigue, improved memory and improved motor function. Considerable variability was observed in both drug and placebo responses among the elderly. A self‐rating depression scale (D30R) was useful for assessing changes in affective states and in discriminating between the effects of active drug and placebo.

Poe, William D.

doi: 10.1111/j.1532-5415.1975.tb00930.xpmid: 1159266

ABSTRACT A geriatrician is something more than a physician who simply cares for old people. The geriatrician should, above all, be well grounded in internal medicine, have a genuine fondness for the elderly and their problems, and be experienced in neurology, psychiatry and rehabilitation medicine. A possible additional role is that of organizer and coordinator of health services for old people.

Gagliano, Louis; Gianturco, Daniel; Ramm, Dietolf

doi: 10.1111/j.1532-5415.1975.tb00931.xpmid: 1080493

ABSTRACT Each geriatric patient has observable problems which can generate treatment goals implemented by a treatment plan. Extensive record keeping would be required to document this tripartite scheme. In practice, either problem‐oriented or goal‐oriented records are used. Problem records tend to drift toward a goal concept, since problems are usually stated in only sufficient detail to serve as a guide to treatment. The results of a problem‐oriented format are described for 143 state hospital patients whose mean age was 74 years. The most common number of problems was 5 per patient. Physical problems were the most frequent (N = 456), followed by behavioral (N = 203), thought‐related (N = 156), administrative (N = 99), affective (N = 69), and attitudinal (N=10). The authors’ experience with both systems leaves them with a preference for the problem‐oriented system with geriatric patients since physical problems are so numerous.

Dastoor, D. P.; Norton, S.; Boillat, J.; Minty, J.; Papadopoulou, F.; Müller, H. F.

doi: 10.1111/j.1532-5415.1975.tb00932.xpmid: 1159267

ABSTRACT Eighty newly admitted psychogeriatric patients were intensively investigated by a variety of disciplines — medical, laboratory, and psychologic‐psychiatric tests, including a Minimal Social Behavior Scale and an Integrative Social Functioning Scale. The sample of patients and methods of study for this 10‐month Geriatric Assessment Program are described. Assessment of present and past social functioning revealed good agreement between ratings made by different staff members. A decline in social functioning with time differentiated organic from functional psychiatric illness. Some of the scales employed may be of value for social screening purposes in the community.

Grauer, H.; Birnbom, F.

doi: 10.1111/j.1532-5415.1975.tb00933.xpmid: 1159268

ABSTRACT This study was carried out to validate a rating scale which could serve as a guide in determining the need for institutional care. The scale assesses the subject's physical and mental disability, balanced against his ability to function and the support available from relatives and community resources. Cut‐off points were tested by the use of an 18‐month follow‐up interval. Initially, 130 aged men and women from three different settings were rated. At the time of follow‐up eighteen months later, 83 per cent of the subjects who had obtained an initial score indicative of their inability to function in the community were either dead or in an institution. In contrast, 90 per cent of those who obtained an initial score indicating that they were able to continue in the community, were not in an institution at the time of follow‐up. The rating scale can be used not only to help decide the need for institutional care, but also to help determine the most suitable setting for the patient if placement is necessary.

Case, Thomas C.; Gillooley, John F.

doi: 10.1111/j.1532-5415.1975.tb00934.xpmid: 1159269

ABSTRACT A case is presented of transitional‐cell cloacogenic carcinoma of the anal canal in a 66‐year‐old woman. Eight years previously she had received radiation therapy for early carcinoma of the uterine cervix, but there was no evidence of recurrence. The rectal carcinoma was therefore regarded as a second primary malignant tumor. This point in differential diagnosis was considered important because of its bearing on the plan of treatment. After abdominoperineal resection of the tumor, the prognosis seemed favorable.

doi: 10.1111/j.1532-5415.1975.tb00935.xpmid: N/A