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Biomedical subjects

R Adolfsson

Publications and source records attributed to R Adolfsson.

At least 73 records · Page 4Linked to original sources
PubMed1990

Prevalence and characteristics of persons with dependency on feeding at institutions for elderly.

The prevalence of dependency on feeding was estimated in 3,607 residents cared for in old people's homes, nursing homes, somatic long-stay clinics, psychiatric long-stay wards and psychogeriatric wards. Ten per cent of the residents were found to be dependent on the staff to eat. The highest proportion was found in nursing homes and somatic long-stay clinics. A considerably larger proportion of the residents with dependency on assisted feeding imposed the highest workload on the staff. Residents who were totally dependent on assisted feeding were more disabled with regard to other ADL functions and also they were demented more often. Loss of the ability to eat was related to an inability in other ADL functions. Support was gained for a hierarchical loss of ADL functions as suggested by Katz & Apkom. Feeding problems seem to be a terminal phenomenon in demented patients.

Activities of Daily Living↗
PubMed1989

Histopathological classification of dementias by multivariate data analysis.

Autopsied brains from 55 demented patients, clinically classified according to DSM-III criteria into AD/SDAT and MID and 19 nondemented individuals were available for this study. Using general clinical, gross neuroanatomical and histopathological data three separate dementia classes, namely AD/SDAT, MID and AD-MID, were visualized in two-dimensional space by multivariate data analysis. This analysis revealed that the pathology in AD-MID patients were not merely a linear combination of the pathology in AD/SDAT and MID, indicating that AD-MID might represent a dementia type of its own.

Aged↗
PubMed1988

Verbal communication and behaviour during meals in five institutionalized patients with Alzheimer-type dementia.

Five institutionalized patients with Alzheimer-type dementia were observed (video-recorded) during meals. The aim was to assess their meal behaviour and social interaction. The results showed that when the patients ate without the participation of staff, the two least demented patients became 'caregivers' in the group and helped the three most demented patients to eat. When two mental nurses joined the group, the patients dropped their roles as helpers. The conversation in the group could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all comprehensible utterances concerned food and eating and almost all conversation concerned the present.

Aged↗
PubMed1988

Monoamine metabolite concentrations and cholinesterase activities in cerebrospinal fluid of progressive dementia patients: relation to clinical parameters.

Forty-five well clinically characterized patients with progressive dementia were investigated for lumbar cerebrospinal fluid (CSF) monoamine metabolites and cholinesterase activities. Monoamine concentrations were determined by reverse phase liquid chromatography with electrochemical detection and the cholinergic enzymes were measured photometrically. Firstly, all clinical and CSF parameters were studied in statistical cluster analyses to detect groups of variables which demonstrated a high correlation with respect to each other. The CSF transmitter markers were then used in multiple regression models to explain the variance of clinical variables as chosen from the cluster analyses. The degree of dementia, as assessed by global deterioration score (GDS) and activity in daily life (ADL) status, as well as the Alzheimer-related symptoms dyspraxia and dysphasia, were associated with low AChE activities in CSF. A presumed subgroup of dementia patients clinically characterized by asymmetry of neurological signs, increased unilateral tonus, stepwise progression, and high Hachinski score, showed low HVA concentrations in CSF. These data suggest a coupling of clinical/neurological parameters to different CSF transmitter profils and, thus, that CSF biochemical parameters are of use as antemortem markers in dementia conditions.

Acetylcholinesterase↗
PubMed1988

Long-term care of the elderly. A descriptive study of 3600 institutionalized patients in the county of Västerbotten, Sweden.

Probands (n = 3607) living in long-term care institutions in the county of Västerbotten were assessed to estimate whether the prevalence of dementia in different types of institutions had changed since a similar survey was made 7 years before. The probands' motoric functions, vision, hearing, speech, prevalence of behavioral disturbances and psychiatric symptoms, work load and use of psychoactive drugs were also investigated with special emphasis on the differences between the demented and the non-demented. About 40% were demented. This proportion of demented patients had increased in somatic long-stay clinics, nursing homes and homes for the aged since 1975. Further, the mean age of the probands and their length of stay had increased in these institutions. Demented probands were more impaired with regard to motor functions, speech, vision, hearing, ADL-functions, behavioral and psychiatric symptoms, and they also imposed a higher work load on the staff than the non-demented. Demented probands were also prescribed psychoactive drugs, i.e. neuroleptics but not minor tranquilizers or antidepressants, more often than the non-demented in accordance with the increased prevalence of behavioral disturbances and psychiatric symptoms.

Aged↗
PubMed1987

Histopathological criteria for progressive dementia disorders: clinical-pathological correlation and classification by multivariate data analysis.

Autopsied brains from 55 patients with dementia between 59-95 years of age (mean age 77.9 +/- 8.1 years) and 19 non-demented individuals between 46-91 years of age (mean age 74.3 +/- 10.5 years) were examined to establish histopathological criteria for normal ageing, primary degenerative [Alzheimer's disease (AD)/senile dementia of Alzheimer type (SDAT)] and vascular (multi-infarct) dementia (MID) disorders. Senile/neuritic plaques, neurofibrillary tangles, microscopic infarcts and perivascular serum protein deposits were quantified in the frontal lobe (Brodmann area 10) and in the hippocampus. The demented patients were classified according to the DSM-III criteria into AD/SDAT and MID. Operationally defined histopathological criteria for dementias, based on the degree/amount of the histopathological changes seen in aged non-demented patients, were postulated. The demented patients were clearly separable into three histopathological types, namely AD/SDAT, MID and AD-MID, the dementia type where both the degenerative and the vascular changes are coexistent in greater extent than are seen in the non-demented individuals. Using general clinical, gross neuroanatomical and histopathological data three separate dementia classes, namely AD/SDAT, MID and AD-MID, were visualized in two-dimensional space by multivariate data analysis. This analysis revealed that the pathology in the AD-MID patients was not merely a linear combination of the pathology in AD/SDAT and MID, indicating that AD-MID might represent a dementia type of its own. The clinical diagnosis for AD/SDAT and MID was certain in only half of the AD/SDAT and one third of the MID cases when evaluated histopathologically and by multivariate data analysis. AD/SDAT, MID and AD-MID were histopathologically diagnosed in 49%, 24% and 27%, respectively, of all the dementia cases studied. Opposite correlation between the number of tangles, plaques and the patient age in non-demented and AD/SDAT cases were observed, indicating that the pathogenesis of tangles and plaques in the two groups of patients might be different and that AD/SDAT might not be a form of an exaggerated ageing process.

Aged↗
PubMed1987

Blood-brain barrier in Alzheimer dementia and in non-demented elderly. An immunocytochemical study.

Peroxidase-antiperoxidase staining of formalin-fixed brain was employed to compare the blood-brain barrier (BBB) function in five patients with Alzheimer's disease/senile dementia of the Alzheimer type (AD/SDAT) and three patients with AD/SDAT combined with multi-infarct dementia (MID/SDAT) with that of six non-demented aged controls. The diffusion of serum proteins through the BBB was visualized with antisera to albumin, prealbumin, immunoglobulin, C1q, C3c and to fibrinogen. A similar patterns of diffusion was seen in AD/SDAT and non-demented aged individuals. Neuron and glial cells were stained with different antisera in the vicinity of the diffusion. Senile (neuritic) plaques were occasionally visualized with antisera to IgG, C1q and C3c but not with antisera to albumin, prealbumin and fibrinogen in both demented and non-demented aged individuals. Neurofibrillary tangles were not labelled with any of the antisera studied. These results indicate that the BBB is compromised equally in AD/SDAT and in the non-demented elderly.

Aged↗
PubMed1987

Cholinergic topography in Alzheimer brains: a comparison with changes in the monoaminergic profile.

The topographical distribution of the choline acetyltransferase (ChAT) activity and the number of muscarinic binding sites was studied in the anterio-posterior direction of the caudate nucleus, hippocampus, globus pallidus and putamen of four subjects with senile dementia of Alzheimer type (AD/SDAT) and in the same regions in six controls. Intranuclear gradients were observed both for ChAT and muscarinic receptors. The data obtained were compared with data on noradrenaline (NA) concentration. With longer duration of the disease a decrease was found in the noradrenergic and cholinergic systems. One patient died acutely after a rather short duration of the disease. In this patient no change in ChAT activity was found while the NA concentration was decreased in all brain regions. An upregulation of the number of muscarinic receptors was observed in the caudate nucleus and putamen of all cases, except for the case with the shortest duration of the disease.

Aged↗
PubMed1987

Nutritional status and dietary intake in institutionalized patients with Alzheimer's disease and multiinfarct dementia.

Nutritional status, dietary intake, weight change, and mortality were studied in a sample of severely demented, institutionalized patients. Dietary intake was registered during five days in two periods, five weeks apart. A weighing method was used. Nutritional status was assessed by anthropometric measurements (weight for height index, triceps skinfold thickness, arm muscle circumference) and determination of circulating proteins (albumin, transferrin, and prealbumin). Energy and/or protein malnutrition was found in 50% of the patients. The mean dietary intake was sufficient according to energy (2059 kcal/day), proteins, vitamins, and minerals. A comparison of patients with or without malnutrition showed no differences in dietary intake, diagnoses, age, length of hospital stay, or duration of illness. However, malnourished patients had had four times as many infectious periods treated by antibiotics as patients with no malnutrition. Thirty-nine of 44 patients lost weight during their hospital stay. There was no correlation between loss of weight, length of hospital stay, or duration of illness.

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PubMed1987

Attitudes of health care personnel toward demented patients.

Health care personnel (n = 724) working in psychogeriatric care, somatic and psychiatric long-term care, somatic and psychiatric general care and in homes for the aged, were interviewed by means of questionnaires evaluating attitudes and intentions regarding work with demented patients and education in their care. The overall attitude towards demented patients was positive. The largest numbers of personnel with positive attitudes were found in psychogeriatric care and somatic long-term care and the lowest in general medical and psychiatric care. The figure for positive attitudes in relation to education showed a similar figure for all categories. Given a free choice only 4% of the respondents had the intention of working solely with demented patients. A majority of the respondents reported that their knowledge of the care of demented patients came from clinical work. There is a strong need for further education.

Adolescent↗
PubMed1986

Morning care of patients with Alzheimer-type dementia. A theoretical model based on direct observations.

Five hospitalized patients in different stages of Alzheimer-type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self-care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance.

Activities of Daily Living↗
PubMed1986

Isoelectric focusing and two-dimensional gel electrophoresis in plasma and cerebrospinal fluid from patients with dementia.

IgG profiles of cerebrospinal fluid (CSF) and plasma from patients with Alzheimer's disease/senile dementia of Alzheimer type, multi-infarct dementia and aged nondemented individuals were analyzed using isoelectric focusing (IEF) followed by immunofixation and high resolution two-dimensional polyacrylamide gel electrophoresis (PAGE). The IEF profiles of plasma and CSF in patients with dementia were diffuse and lacked oligoclonal bands and were identical to those of nondemented individuals. The investigation of plasma and CSF by two-dimensional PAGE did not reveal any specific protein pattern in the demented individuals compared to the controls.

Adult↗
PubMed1985

Catecholamine topochemistry in human basal ganglia. Comparison between normal and Alzheimer brains.

Analysis of catecholamine levels in postmortem human control and Alzheimer brains revealed lower mean concentrations of noradrenaline, but not dopamine, in nucleus caudatus, putamen and globus pallidus, but not in hippocampus, of the Alzheimer brains. Generally, noradrenaline levels were higher in the more posterior parts of nucleus caudatus and putamen in the control brains, whereas such gradients were absent in the Alzheimer brains.

Aged↗
PubMed1985

Perivascular deposits of serum proteins in cerebral cortex in vascular dementia.

Immunocytochemical techniques were used to study the histopathologic changes in vascular dementia, i. e., both multi-infarct dementia (MID) and MID combined with Alzheimer changes (MID/SDAT). In eight of 13 of the dementia cases strongly immunostained deposits of plasma proteins were observed around numerous capillaries of layers I-IV of frontal grey matter. Each of these deposits contained albumin, prealbumin, IgG, C1q, C3c, and fibrinogen. No such deposits were found in any of the seven non-demented aged controls. In contrast, in white matter in both demented and normal aged control cases only weak immunostaining of serum proteins was observed which gradually decreased with the distance from the vessels. The presence of heavy deposits of serum proteins exclusively around the capillaries of the gray matter in cases with vascular dementia may indicate a defect of the cortical capillary system which might play a role in the clinical symptoms seen in vascular dementia. The enrichment of C1q within the deposits is intriguing as this might occur because of the binding of C1 through its subunit C1q to the antibody-antigen complex and thereby support a possible immunologic involvement in the formation of these deposits.

Aged↗