Biomedical subjects
R Logsdon
Publications and source records attributed to R Logsdon.
Anxiety and Alzheimer's disease.
This study investigated symptoms of anxiety in two samples of clinic outpatients diagnosed with Alzheimer's disease (AD). Clinician and caregiver reports were obtained using standardized measures to characterize a broad array of anxiety symptoms. Anxiety symptoms were reported for a substantial proportion of subjects, regardless of whether clinician or caregiver ratings were used. Anxious or worried appearance was most common (68% to 71%), followed by fearfulness, tension, restlessness, and fidgeting (37% to 57%). Sleep disturbance and various somatic symptoms were less common (8% to 34%). Although anxiety symptoms were prevalent, only 5% to 6% of subjects met Diagnostic and Statistical Manual of Mental Disorders criteria for the diagnosis of generalized anxiety disorder. In both samples, anxiety symptoms were associated with depression, behavioral disturbances, and increased cognitive impairment. Study findings support a high occurrence of anxiety in patients with dementia, and treatments for anxiety might therefore be helpful in reducing the psychiatric burden of AD.
Measuring behavior, mood, and psychiatric symptoms in Alzheimer disease.
Behavioral disturbances, psychiatric symptoms, and mood disorders are prevalent, persistent, and debilitating aspects of the clinical course of Alzheimer disease. The authors discuss the phenomenology of these problems, their importance in understanding disease course and planning treatment, and the current state-of-the-art methods for assessment. Issues to consider in assessment of these problems also are discussed.
Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist.
The Revised Memory and Behavior Problems Checklist (RMBPC), a 24-item, caregiver-report measure of observable behavioral problems in dementia patients, provides 1 total score and 3 subscale scores for patient problems (memory-related, depression, and disruptive behaviors) and parallel scores for caregiver reaction. Data were obtained from 201 geriatric patients and their caregivers. Factor analysis confirmed 3 first-order factors, consistent with subscales just named, and 1 general factor of behavioral disturbance. Overall scale reliability was good, with alphas of .84 for patient behavior and .90 for caregiver reaction. Subscale alphas ranged from .67 to .89. Validity was confirmed through comparison of RMBPC scores with well-established indexes of depression, cognitive impairment, and caregiver burden. The RMBPC is recommended as a reliable and valid tool for the clinical and empirical assessment of behavior problems in dementia patients.
Assessment and management of behavioral disturbances in Alzheimer's disease.
In summary, AD patients and their care givers are confronted with a variety of behavioral problems that may have a devastating impact on both. It is important for physicians and other health-care providers to assess the occurrence and impact of these behaviors, and to assess and treat the broader medical and cognitive problems that are evident. Measurement tools can augment the clinical interview to give the practitioner a thorough assessment of behavioral problems. A systematic six-step approach to intervention, as well as specific recommendations for the most common and troublesome behaviors of depression and agitation, are provided. Care givers vary in their ability to cope with the problems of AD patients. Some seem to adjust naturally and to anticipate and solve problems on their own. Others need considerable guidance and may require assistance from their physician as well as referral to a psychologist or other mental health professional adept in behavioral management. Physicians must play a pivotal role in recognizing problems and providing or arranging for appropriate treatment for their AD patients and care givers.
Secorbarbital and perceptual processing.
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Utilization review: whose responsiblity? What are its potentials?
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Quantifying behavioral disturbance in Alzheimer's disease patients.
In the course of a four-month study of interventions for behavioral disturbances in Alzheimer's disease (AD) patients, the following assessment instruments were examined for validity: the clinical global impression of change (CGIC), Cohen-Mansfield agitation inventory (CMAI); CERAD behavioral rating scale for dementia (BRSD), revised memory and behavioral problems checklist (RMBPC) and the agitated behavior in dementia scale (ABID). The four specific behavioral/agitation scales had excellent cross-sectional and longitudinal correlations with each other, suggesting high validity, but changes as indicated by CGIC scores did not correlate well with change scores on the other instruments. We conclude that specific behavioral instruments are preferable to the more general CGIC for detecting and quantifying behavioral disturbances in AD patients.