PubMed Health⌕ Search

Biomedical subjects

B B Reiss

Publications and source records attributed to B B Reiss.

13 recordsLinked to original sources
PubMed1991

Does early intervention reduce the number of elderly people with dementia admitted to institutions for long term care?

OBJECTIVE: To test whether early diagnosis and practical help reduce the number of elderly people with dementia admitted to institutions. DESIGN: Controlled trial of effect of help from a multidisciplinary team on admission rates of people with dementia. SETTING: Seven general practices in Cambridge. SUBJECTS: 2889 subjects aged 75 and over, of whom 159 were identified as having dementia with a two stage community survey. Eighty six subjects were referred for extra help if they or their supporters wished. The other 73 subjects had access to the usual services and served as controls. INTERVENTION: Subjects and families in the action group were offered a wide range of help, including financial benefits, physical aids, home helps, respite admissions, practical advice, and psychiatric assessments. MAIN OUTCOME MEASURE: Permanent admission to long term care within two years after diagnosis. RESULTS: Early intervention did not affect admission rates in subjects who lived with supporters. By contrast, nine of the 14 (64%) subjects with moderate or severe dementia living alone were admitted in the action group in the study's second year compared with only one of 13 (8%) controls (p = 0.004). CONCLUSIONS: Some people with moderate or severe dementia who lived alone and were at serious risk may have been identified earlier by the resource team. Without the team these people would not have become known to the responsible authorities until families, neighbours, and wardens became unable to cope. The study was conducted during the team's formative period, however, and greater experience might have allowed some subjects to remain at home for longer.

Aged↗
PubMed1991

Shoulder disorders in the elderly: a community survey.

A community survey of identifiable symptomatic shoulder disorders in a sample of 644 elderly people over age 70 (318 male and 326 female) revealed a prevalence of 21%. Shoulder disorders were more common in women (25%, versus 17% in men). Approximately 70% of the cases of shoulder pain involved the rotator cuff. Fewer than 40% of the subjects sought medical attention for these symptoms. Increased medical awareness is needed, since the elderly often do not volunteer information about such symptoms.

Aged↗
PubMed1990

Memory complaints and impairment in normal, depressed, and demented elderly persons identified in a community survey.

Normal, depressed, and demented elderly persons who were identified by means of a community survey were asked to assess their memories and to complete a battery of memory tests. Depressed elderly persons reported memory problems more often than normal subjects and reported indecisiveness, impaired concentration, and mental slowing more often than demented subjects. However, memory complaints and memory performance correlated poorly in the normal and depressed groups. Normal and demented elderly persons who reported memory problems achieved higher scores on a series of questions about depression than those who denied memory problems.

Aged↗
PubMed1990

Problems reported by relatives in a community study of dementia.

The supporters of 120 demented elderly people completed rating scales of the frequency and severity of the problems they faced, the amount of strain they experienced and their psychological well-being. Problems and strain increased with the degree of dementia. Problems relating to physical dependency, forgetfulness and inertia were relatively common, while disturbed behaviours were relatively uncommon. Physical dependency and disturbed behaviour were less well tolerated than forgetfulness and inertia, but all problem categories were positively associated with measures of strain. Wives reported more problems and strain than husbands, and co-resident children were under greater strain than children who lived independently.

Activities of Daily Living↗
PubMed1989

The reliability and validity of the Mini-Mental State in a British community survey.

The Mini-Mental State (MMSE) was administered to 2302 general practice patients aged 75 yr and over. Those scoring 23 or less and a sample of those scoring 24 or 25 were selected for further investigation using the Cambridge Mental Disorders of the Elderly Examination. Inter-observer reliability was high with a mean kappa value of 0.97. Eighty-six per cent of respondents judged to have organic mental disorders scored 23 or less on the MMSE and 92% of those judged to be cognitively intact scored 24 or more. However, only 55% of respondents who scored 23 or less were demented or delirious while a number of relatively well educated, mildly demented subjects scored 24 and 25. The customary cut-off point of 23/24 may need to be revised in future community studies. MMSE scores cannot be used to make even tentative psychiatric diagnoses; more detailed investigation of low scorers is essential.

Aged↗
PubMed1989

The influence of education, social class and sex on Mini-Mental State scores.

The Mini-Mental State Examination was administered to 1865 general-practice patients aged 75 years and over. Even when demented cases were removed from analysis, respondents with relatively little education, together with those in social classes III-manual and below, were significantly more likely to score below the cut-off point used in North American community surveys to denote 'cognitive impairment'. Education and social class influenced scores on all sections within the MMSE with the exception of registration. Sex influenced scores on tests of calculation and spelling backwards but had no effect on total scores. These findings emphasize the importance of investigating low scorers in more detail before making a diagnosis of dementia.

Aged↗
PubMed1989

A community survey of mental and physical infirmity in nonagenarians.

One hundred and thirty-two people aged 90 years and over were identified in a study of the prevalence of dementia. One third lived in institutions, a third were demented and half were unable to prepare a simple meal or do light housework. None was entirely free of mental or physical disability but many functioned satisfactorily at a simple level with the help of family members and the domiciliary services.

Aged↗
PubMed1989

The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination.

General practice patients aged 75 years and over were screened for cognitive impairment using the Mini-Mental State Examination. Those scoring 23 or below and a sample of those scoring 24 or 25 were assessed using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX), a structured interview schedule specifically designed to detect mild dementia. The CAMDEX includes a mental state examination, a psychiatric history, detailed cognitive testing and an information interview. The prevalence of dementia in 2311 patients was found to be 10.5%, about half that found in most earlier studies. Possible reasons for this low rate are discussed.

Aged↗
PubMed1988

Do general practitioners miss dementia in elderly patients?

General practitioners and community nurses were asked to rate the likelihood of dementia for each of their elderly patients. Cases of dementia were identified by research psychiatrists using the Cambridge mental disorders of the elderly examination (CAMDEX), a new structured diagnostic interview. General practitioners correctly identified dementia as at least a possibility in 121 of the 208 cases found. Nevertheless, they mistakenly rated as demented several patients suffering from functional psychiatric disorders, in particular depression. Community nurses correctly identified dementia as at least a possibility in 64 of the 74 demented patients known to them, but they incorrectly suspected dementia in a greater proportion of instances. Both general practitioners and families appeared to have low expectations of what general practice has to offer demented elderly people. General practitioners should take the initiative in diagnosing dementia in very elderly patients who show signs of the condition. In some cases it may be secondary to treatable disorders, and in others all that may be required are understanding, support, and advice to families.

Aged↗
PubMed1980

Teachers in general practice: a comparative study.

Thirty-nine randomly selected general practitioners in the Cambridgeshire Health Area were surveyed in an attempt to determine whether there were prior differences between those practitioners who choose to become involved with undergraduate medical students and those who choose not to. Teachers were found to have graduated more recently, subscribe to more journals and were more likely to use medical libraries than non-teachers. All the solo practitioners in the study and two of the four practitioners in two-man groups belonged to a subgroup of non-teachers who had never had students and did not want students in the future. This subfroup also subscribed to fewer journals than the other groups, bought fewer textbooks and used medical libraries less. The only prior differences between teachers and non-teacher that have been demonstrated are year of graduation and type of practice. Other differences could well be attributed to the influence of the students themselves. Studies are needed to clarify this issue, especially as it realates to continuing medical education.

Education, Medical, Continuing↗
PubMed1965

Asian influenza in 1963 in two general practices in Cambridge, England.

A clinical, epidemiological and virological investigation was conducted on patients in two general practices in Cambridge, England, during an influenza epidemic between February and April 1963. The epidemiological pattern differed from that of the 1957-58 Asian influenza epidemic in that the overall incidence was considerably lower (3.2%) and that the highest attack rates were not in school children but in pre-school children (71.5 per 1000 persons).Virological investigation confirmed the diagnosis of Influenza A2 infection in 56 of 63 patients (89%). Isolations were made in 29 of 51 specimens tested. Serological studies revealed that the complement fixation test was more reliable than hemagglutination - inhibition or neutralization tests. Clinical features resembled those reported in previous epidemics, cough, headache and limb pains being prominent features.

Adolescent↗