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Biomedical subjects

K Bolla-Wilson

Publications and source records attributed to K Bolla-Wilson.

12 recordsLinked to original sources

Absence of depression in elderly adults.

Depressive symptomatology has been reported to be most prevalent over the age of 65. This study examined the effects of age (young less than or equal to 60 years, old greater than 60 years) and sex on the Beck Depression Inventory (BDI), MMPI Scale 2 (Depression), and Geriatric Depression Scale (GDS). Responses to somatic versus psychological complaints on the BDI were examined separately, and the physical malfunctioning subscale (D3) of the MMPI-2 was also evaluated. No age effects were found on any of the depression scales' total scores. On the BDI, the older group reported more somatic complaints than the younger group. Psychological complaints were reported equally for young and old groups. Women reported more depressed items on the MMPI-2 and reported a greater number of symptoms of physical malfunctioning (D3) than men for both age groups. No age by sex interaction reached significance. A report of greater physical malfunctioning (D3) was significantly associated with higher scores on all the depression scales. The increased prevalence of somatic complaints on self-report depression scales probably results in higher scores, which are misinterpreted as representing more depression in the elderly population. It is recommended that a depression scale such as the GDS, which excludes somatic items, be used to assess depression in older adults.

Adult↗

The MMPI: regional difference or normal aging?

The Minnesota Multiphasic Personality Inventory (MMPI) is currently undergoing a process of revision and renormalization. Of particular concern is whether or not there is a need to develop separate normative tables for elderly subjects. Colligan, Osborne, Swenson, & Offord (1983) tested a large group of healthy subjects who ranged in age from 18 through 99. Their investigation uncovered numerous significant relationships between test taker age and scores on various scales of the MMPI. The present study looked at the MMPI profiles of 214 healthy men and women between the ages of 39 and 89. The results gleaned from this investigation do not reflect the same intensity of age-related changes that are reported by Colligan et al. (1983) and other similar studies. More specifically, we were unable to detect the age-related elevations in the "neurotic triad" (Hs, D, Hy scales) that have often been cited by other researchers. Additionally, we were not able to support the typically reported aging effects in scales Mf, Pa, Pt, and Si. We suggest that these and other similar differences may be attributed to geographic, societal, and population factors.

Adult↗

Lateralization of dementia of depression in stroke patients.

In a group of stroke patients with left-hemisphere lesions, those with major depression performed significantly below nondepressed patients on four of nine cognitive domains examined with a neuropsychological test battery. Among patients with right-hemisphere stroke, those with major depression did not perform below nondepressed patients on any of the nine cognitive domains. The differential effect of depression on cognitive performance between left- and right-hemisphere lesion groups could not be accounted for by demographic variables, neurological symptoms, lesion location, or lesion size. Poststroke major depression appeared to produce a decline in cognitive performance or dementia of depression that depended on the laterality of the lesion.

Brain↗

Reversible dementia with idiopathic hypereosinophilic syndrome.

A 66-year-old woman with hypereosinophilic syndrome became rapidly demented. Evaluation revealed CSF eosinophilia, background slowing on EEG, and periventricular MRI abnormalities. Following steroid therapy, there was rapid resolution of the dementia and normalization of CSF and EEG. These findings support the concept of a direct neurotoxic effect on the human CNS produced either by eosinophils or possibly by eosinophil-derived neurotoxins.

Aged↗

Age-related sex differences in verbal memory.

Verbal learning and memory were studied in 196 healthy men and women aged 40 to 89. The Rey Auditory Verbal Learning Task (RAVLT), a 15-word list, was presented over five trials followed by free recall after each trial. A recognition trial of 50 words subsequently was administered. A stepwise regression that examined the contributions of age, sex, and vocabulary on the five trials of the RAVLT showed that age and sex accounted for a significant portion of the variance on each trial. Vocabulary accounted for a significant portion of the variance only on trials 4 and 5. The recognition trial was not affected by age, sex, or vocabulary. Men had lower scores overall as compared to women. In the older age group (ages 66-89), this difference was significant on trials two through five. Possible mechanisms that may underlie these age-related sex differences in learning curves are discussed.

Adult↗

Age-specific norms for the Mini-Mental State Exam.

We administered the Mini-Mental State Exam (MMSE) to 194 healthy men and women, ages 40 to 89 years. Total score was significantly associated with age (p less than 0.0001), but not vocabulary, education, Beck's Depression Inventory Score, or sex. The lowest quartile cutoff scores for the MMSE by decade were 40s - 29; 50s - 28; 60s - 28; 70s - 28; and 80s - 26. When screening for progressive decline in cognitive performance, the use of age-specific norms may provide greater sensitivity than the present recommended cutoff score of less than 24.

Adult↗

Conditioning of physical symptoms after neurotoxic exposure.

Psychologic reactions to a neurotoxic exposure can produce prolonged physical symptoms which are as debilitating as the direct effects of the neurotoxic substance. A group of patients exist who experience reoccurrence of exposure-related symptoms when exposed to a variety of common environmental substances, such as perfume, gasoline, and cigarette smoke. We propose a classical conditioning model to explain the development of this phenomenon. Identification and treatment of these individuals are also discussed.

Adult↗

Neuropsychological impairment following inorganic arsenic exposure.

A 50-year-old chemical engineer, routinely screened for occupational arsenic exposure, was admitted with a delirium for which no known etiology was found. Elevated levels of arsenic were found in the urine and hair. The patient received chelation treatment with British anti-Lewisite; substantial amounts of arsenic were excreted and the toxic encephalopathy improved gradually over the 8-month follow-up period. The patient was tested at 6 weeks, 4 months, and 8 months postdelirium with a battery of neuropsychological tasks. The pattern of results showed verbal learning and memory to be severely impaired while tests of general intellectual abilities and language remained unaffected. Follow-up examinations with no subsequent reexposure revealed improvements on specific cognitive tasks. It is unclear whether recovery of cortical functions occurred or if compensatory strategies were developed. It is proposed that a subacute exposure to arsenic may have contributed to the neuropsychological deficits.

Arsenic↗

Depression influences intellectual impairment in stroke patients.

Patients with ischaemic lesions of the left cerebral hemisphere were examined for depression and intellectual impairment: in non-depressed patients, the severity of impairment was related to both lesion volume and location, as assessed by CT scan analysis. Cognitive impairment in patients with major depression was greater than predicted by lesion volume alone, and when patients were matched for severity of impairment, depressed patients had smaller lesion volumes than the non-depressed. After six months, non-depressed patients had significantly less cognitive impairment than depressed patients who showed no improvement. Both depression and lesion volume were significantly and independently related to cognitive impairment. These findings suggest that post-stroke depression can produce a true dementia in its own right, and that treatment of post-stroke depression might benefit cognitive function.

Adult↗

Mood disorders in left-handed stroke patients.

Thirty left-handed patients hospitalized for stroke were examined for mood disorders. Patients with left hemisphere lesions and nondominant hand impairments had significantly higher depression scores and more depressive diagnoses than patients with right hemisphere lesions and dominant hand impairments. Major depression was strongly associated with left anterior brain injury, and depression severity was significantly correlated with proximity of the lesion on CAT scan to the left frontal pole. These findings are almost identical to previously reported results from right-handed patients and suggest that cerebral lateralization of poststroke mood disorders may be independent of cerebral motor dominance and language dominance.

Aphasia↗

Phonologic agraphia in a left-handed patient after a right-hemisphere lesion.

Oral and written spelling were evaluated in a left-handed patient with a right-hemisphere infarct and right-hemisphere language representation. Spelling was intact for different classes of words, but there was severe difficulty in both oral and written spelling of nonwords. This pattern was consistent with phonologic agraphia. There was selective disruption of the segmentation component, with intact phoneme-to-grapheme conversion supporting the Roeltgen and Heilman hypothesis of two-system spelling after lesions in the left supramarginal gyrus. This is the first case of phonologic agraphia after right supramarginal gyrus damage in a left-handed patient.

Adult↗