Correlation of cholinergic abnormalities with senile plaques and mental test scores in senile dementia

Necropsy brain tissue from normal (control) patients and patients with depression and dementia was examined for activities of various cholinergic components, and these related to the degree of senile plaque formation and extent of intellectual impairment. Choline acetyltransferase and acetylcholinesterase activities decreased significantly as the mean plaque count rose, and in depressed and demented subjects the reduction in choline acetyltransferase activity correlated with the extent of intellectual impairment as measured by a memory information test; muscarinic cholinergic receptor binding activity remained unchanged with increasing senile plaque formation but butyrylcholinesterase activity increased. The results suggest a close relation between changes in the cholinergic system and Alzheimer's dementia, but the precise role of the system in this disease remains to be elucidated.

[Perilymphatic perfusion of the cochlea (guinea pig) with fluorocarbon emulsion (author's transl)]

Because oxygen is at least ten times as soluble in fluorocarbon liquids as in plasma or saline, we investigated the principle possibility of perilymphatic perfusion of the cochlea with perfluortributylamin. Our experiments show that fluorocarbons in spite of the excellent O2-solubility in it are not suitable for the perilymphatic perfusion due to their physical properties (density 1.91 g/ml, non-solubility in water, necessity and difficulties of emulsification).

Management of the demented elderly patient in the community

Eighty-three consecutive patients with organic mental disorder were studied on their first admission to a psychiatric day hospital assessment unit in a general hospital. They were evaluated medically, psychiatrically and by social work, re-evaluated after 3 months, and again after 12 months or at death. The types of care, and the number of days in each setting, were recorded. Nearly three-quarters were dead or in institutions by 12 months: those initially living with spouses did worst, and those with their children did best, while those on their own became long-stay residents in institutions. Family support seeemed the most important factor determining continued life in the community, and increased help to families from social services appeared to be needed. The value of earlier psychiatric diagnostic and earlier treatment of physical ills is also discussed.

Psychiatric illness in the elderly. A comparison of GP records and survey findings

The GP records of 200 elderly people living at home were scrutinized and estimation made of physical and psychiatric disability. These estimations were compared with those made independently by a psychiatrist interviewing the subjects at home. There was a reasonable agreement between the two assessments of functional disorder and between the two assessments of physical disabilities. Whereas the survey psychiatrist's diagnoses of mental disorder correlated positively with the presence of physical illness, this did not hold for those considered to have evidence of psychiatric illness using GP records alone. The duration of a positive psychiatric history obtained from GP records was consistent with a discrimination between late onset (recent) and chronic neurosis.

A visual tracking machine

The Visual Tracking Machine is an easily constructed device used for perceptual training with adults and children-with the following diagnoses: cerebral vascular accident, traumatic head injury, cerebral palsy, mental retardation, and spina bifida. It offers activities for the following purpose: development of visual attention and eyemotility, stimulation to cross the midline, compensation iraining for homonymous hemianopsia, one-side neglect, eye-hand coordination, and motor planning. The machine features control over smoothness, speed, and direction of movement of a visual stimulus, eliminates a potentially distracting background, spans the whole visual field, motivates the patient by offering the opportunity for many challenging games, and offers variability in task difficulty. It is sturdily built, relies only on manual power, and is not prone to mechanical breakdown. Used successfully during a one-year trial period, it appears to be a potentially useful adjunct to perceptual training programs. A description of its construction and materials needed are included. Other devices promoting tracking are reviewed in terms of function, source, and availability.

Cognitive function and length of survival in elderly subjects living at home

177 people aged 65 or over, chosen at random from larger representative samples of elderly people living at home in Newcastle upon Tyne, were given the Weschler Adult Intelligence Scale (WAIS) or a shortened form of it, and followed up for 7 years or till death. Discriminated function analysis showed that the power of the test score to predict death occurring within 2 years was not explained away by its correlations with age, sex, social class or physical disability. Exclusion of clinically diagnosed chronic brain syndromes reduced but did not abolish the relationship found to exist between test score and outcome. The ascertainment of impaired cognitive functioning has important applications in the assessment of prognosis and in the planning of care of elderly people.

The characteristics of old people receiving and needing domiciliary services: the relevance of psychiatric diagnosis

A sample of 447 people aged 65 years and over, randomly selected from electoral rolls, were visited in their homes, independently, by a medical social worker and a psychiatrist. Twelve per cent were receiving domiciliary services from the Local Authority and a further 20% were considered to require them. The types of services received and recommended are described and the medical, social and psychiatric services of those receiving services, in need of them, and the remainder are compared. The high priority for the support of persons with chronic brain syndrome and their relatives is emphasized. Functional psychiatric symptoms were found by the psychiatrist, in a high proportion of those considered by the medical social worker to need services. Psychiatric assessment and treatment which might reduce the need for social services in some cases, would be greatly assisted by the development of a reliable screening device for the use of the primary care team.

[Experiments on the medicamental treatment of the noise-induced cochlear damage. Part I. The effect of dipyridamol and allopurinol on the RMP of the cochlea (guinea pig) after noise (author's transl)]

Dipyridamol has in addition to a coronardilatating effect an ati-thrombotic one too. Moreover it facilitates the release of O2 from haemoglobin by increase of the concentration of 2,3-diphosphoglycerate in the erythrocytes. Allopurinol causes a potential resynthesis of ATP in the cells by inhibition of the metabolism of uric acid. Both substances therefore seemed to be suitable for a medicamental therapy of the noise-induced cochlear damage. The expected favourable effect of Dipyridamol and Allopurinol on the organ of Corti after sound exposure (RMP-measurement before and after exposure to pure tone 120 dB SPL) however had not been confirmed by experiment on animals (guinea pig).

Disposition of beta-methyldigoxin in man

The time course of radioactivity in plasma and the excretion in urine and faeces over 7 days were determined in 12 healthy subjects after single oral and intravenous doses of a solution of 3H-beta-methyldigoxin. 62.2 +/- 2.1 and 29.0 +/- 5.2 per cent of the dose were excreted in urine and faeces, respectively, within 7 days of intravenous administration, compared with 55.2 +/- 2.8 and 28.6 +/- 5.7 per cent after oral administration. This indicates almost complete absorption of the glycoside when given in solution. 12 hours after its administration a pseudo-distribution equilibrium was reached and the average half life of tritiated compounds was 1.3 days. By 48 - 96 hours after treatment the average half life was 2.8 days. O-demethylation was revealed as the main metabolic degradation step in man. The rate of Demethylation was higher after oral than i.v. administration. Thus, only 31% of the radioactivity excreted in the urine consisted of unchanged beta-methyl-digoxin after oral administration compared to 51% after i.v. dosing. Only traces of bis- and monoglycosides were excreted in urine, but there were considerable amounts in faeces, where they accounted for more than 35% of the total excretion. Up to 40% of the radioactivity in plasma and urine consisted of polar conjugates during the first 12 hours after administration of beta-methyldigoxin. The mono- and bisglycosides were identified as the main products of conjugation. During the 7 days approximately 15% of the administered dose was metabolized by splitting off glycosidic bonds and conjugation to polar compounds.

[The effects of methodical factors on the microphonic potential in the guinea pig cochlea with perfusion of perilymph]

The decreas in microphonic potentials detected from the round window (RMP) is negligible only if the bores are located very close to the round window, whereas it will increase with increasing distance from it. Only at pressures of more than +/- 30 cm water column, in rare cases even below that, will a sharp decrease in the RMP occur, possibly because of a lesion of either the oval or the round windown membrane. At a perfusion pressure above +5.6 cm water column, the perfusion liquid will enter the cerebrospinal fluid space. At a lower pressure the perfusion liquid is diluted by cerebrospinal fluid via the cochlear aqueduct. The perfusion speed of 1 to 50 mul/min has no effect on the function of the organ of Corti.

Intelligence and neurosis in old age

In a previous study of old people living in the community, those with functional psychiatric disorders (usually neuroses) were found to have relatively low IQs on the Wechsler Adult Intelligence Scale (WAIS) (Britton et al., 1967). This observation required confirmation and was open to a number of interpretations.