Biomedical subjects

C G Canfield

Publications and source records attributed to C G Canfield.

4 recordsLinked to original sources

PubMed1988

Characterizing patient dysfunction in Alzheimer's-type dementia.

Although Alzheimer's-type dementia (ATD) is characterized by global intellectual deterioration, few systematic efforts have been made to characterize overall dysfunction of ATD patients. The Sickness Impact Profile (SIP) was administered to ATD patients and family members to determine the concurrent validity of family member assessments of functional status. Using the Mini-Mental State score and modified Dementia Rating Scale as validation criteria, family member SIP scores showed consistently higher correlations with the Mini-Mental State and modified Dementia Rating Scale than did patient scores. Comparing family member SIP scores for ATD and nondemented patients revealed that ATD patients maintained high levels of psycho-social dysfunction at both initial evaluation and 1-year follow-up. By contrast, ATD patients showed high levels of physical dysfunction relative to nondemented patients only at follow-up. Physical deterioration over time is also suggested by comparison of ATD patient initial and follow-up scores. This study documents the well-known psychosocial dysfunction in ATD and emphasizes the importance of physical dysfunction as the disease progresses.

Activities of Daily Living↗

PubMed1986

Diagnostic tests in the evaluation of dementia. A prospective study of 200 elderly outpatients.

We studied the components of the diagnostic evaluation in 200 patients older than 60 years of age with suspected dementia who received standardized diagnostic evaluation and follow-up. The most common dementia diagnoses were Alzheimer's-type dementia (74.5%) and dementia due to toxic effects of drugs (9.5%). Eleven patients with hypothyroidism, metabolic encephalopathies due to hyponatremia, hyperparathyroidism, and hypoglycemia required laboratory tests for diagnosis, whereas the other dementia diagnoses were made primarily on the basis of data available on the history and physical and neurologic examinations. The complete blood cell count, blood chemistry battery (especially sodium, calcium, and glucose concentrations), and thyroid function tests were of definite value for the diagnosis of unsuspected disease and were useful as routine tests in evaluating patients for dementia. A careful history and physical examination accompanied by complete blood cell count, chemistry battery, and a thyroid function test would have been effective in diagnosing treatable illnesses causing cognitive impairment. Other diagnostic tests could have been used selectively based on results of the examination and screening tests. Estimated diagnostic charges from a selective approach would be 25% to 34% of those for the "routine" evaluation.

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PubMed1986

Features of potentially reversible dementia in elderly outpatients.

A standardized evaluation was carried out in two separate groups of patients with dementia to determine the features that characterize those with potentially reversible or treatable dementia. In both groups, Alzheimer's-type dementia was the most common diagnosis (65% and 70%); the most common cause of potentially reversible cognitive impairment was medication toxicity. In both groups, patients with potentially reversible dementia had a shorter duration of symptoms, less severe dementia and used more prescription drugs. Because of this association, these features may be considered risk factors but are not distinguishing or diagnostic features of patients with potentially reversible dementia. Other, previously undetected, treatable illnesses not often considered in the differential diagnosis of potentially reversible or treatable dementia were also prevalent in these patients.

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PubMed1985

Diagnostic evaluation of 200 elderly outpatients with suspected dementia.

A standardized diagnostic evaluation was performed on 200 consecutive patients over age 60 with suspected dementia. Diagnoses were confirmed by consensus and subsequently by follow up. Over 70% had Alzheimer's type dementia; 31% had more than one illness contributing to the dementia state, with overlap between the two groups. The most common so-called "treatable" illnesses were drug toxicity, hypothyroidism, and other metabolic diseases; 248 other medical diseases were recognized in 124 patients. Improvement occurred in 55 patients (27.5%) and persisted in 28 (14%) for at least a year during follow up, but only 2 patients recovered normal mental function. Our results emphasize the importance of recognizing and treating the multiple illnesses that contribute to dementia in elderly adults. The distribution of illnesses in demented elderly outpatients is different from that reported in younger patients with dementia. Diagnostic strategies and expectations need to be based on data obtained from studies of elderly patients with suspected dementia.

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