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Biomedical subjects

R Sulkava

Publications and source records attributed to R Sulkava.

At least 91 records · Page 5Linked to original sources
PubMed1988

EEG in the differential diagnosis between Alzheimer's disease and vascular dementia.

Demented patients with Alzheimer's disease (AD) (n = 67), multi-infarct dementia (MID) (n = 77) and probable vascular dementia (PVD) (n = 45) were studied with electroencephalography (EEG). All patients underwent a routine EEG examination and quantitative EEG was recorded from 14 patients with AD, 20 with MID, and 12 with PVD. The patient groups did not differ in regard to sex, age, education, or degree of dementia. Diffuse abnormality of EEG increased in AD, while driving response to photic stimulation and the mean frequency of background activity decreased in all groups with increasing degree of dementia. In quantitative EEG, the percentage of alpha power decreased and those of theta and delta power increased relative to the degree of dementia. Focal abnormalities, and irritative (spikes and/or sharp waves) and slow wave paroxysms were more common in MID than in AD. Patients with different types of dementia did not differ significantly in regard to diffuse abnormality, occurrence of driving response, mean background frequency, or parameters of quantitative EEG. The mean frequency of background activity and the degree of diffuse abnormality correlated with central and cortical atrophy, white matter low attenuation seen on computed tomography, and with neuropsychological findings.

Adult↗
PubMed1988

Cerebrospinal fluid neuron-specific enolase is decreased in multi-infarct dementia, but unchanged in Alzheimer's disease.

Cerebrospinal fluid (CSF) levels of neuron-specific enolase (NSE) were measured in 22 patients with probable Alzheimer's disease and in 35 patients with multi-infarct dementia, and in 15 controls. CSF NSE in patients with Alzheimer's disease did not differ from those in controls. In patients with multi-infarct dementia without recent vascular events CSF NSE was lower than in controls or in Alzheimer patients. This finding is in accord with the prevailing opinion that vascular dementia is caused by multiple infarcts and not by continuous neuronal ischaemia.

Aged↗
PubMed1988

Is determination of plasma lipids useful in the differentiation of multi-infarct dementia from Alzheimer's disease?

Plasma triglycerides, total cholesterol and high-density lipoprotein cholesterol were studied in patients with Alzheimer's disease (AD, n = 57, mean age 70 years) and multi-infarct dementia (MID, n = 69, mean age 73 years) when the patients were admitted for assessment. Both total cholesterol and high-density lipoprotein cholesterol but not triglycerides were lower in MID than in AD even though there was a considerable overlap. Especially in younger patients and in patients living at home the difference was not statistically significant. Further, the plasma lipid values in neuropathologically confirmed cases with AD (n = 5) and MID (n = 16) were similar at admission. Low total cholesterol and high-density lipoprotein cholesterol were related to cardio- and cerebrovascular disorders, living in institutions, and negatively correlated to age and severity of dementia. Our results suggest that determination of total cholesterol and high-density lipoprotein cholesterol is of minor value in the differential diagnosis between AD and MID and that associated diseases, such as coronary heart disease, cardiac failure and arterial hypertension, are more important in this respect.

Adult↗
PubMed1987

Serum lipids and fatty acids in ischemic strokes.

Lipid analysis of different constituents in the blood of patients with stroke revealed that an increased level of total serum cholesterol was infrequently (that of triglycerides more frequently) associated with stroke in middle-aged men, whereas the high-density lipoprotein cholesterol content was low in all but young patients with stroke. High contents of cholestanol and low contents of n-6 polyunsaturated fatty acids predict the development of stroke in middle-aged men and are found in both middle-aged men with stroke and elderly patients with multi-infarct dementia. Young patients with unexpected stroke had normal serum sterol, triglyceride, and fatty acid contents but markedly reduced arachidonic acid levels in the platelets, a change that was normalized by treatment with aspirin. The results emphasize that the etiopathogenesis of ischemic brain damage may vary markedly from one age group to another.

Adult↗
PubMed1987

Fatty acids of plasma lipids, red cells and platelets in Alzheimer's disease and vascular dementia.

Fatty acids of plasma lipids, red cells and platelets were analyzed from 38 demented patients (age 53-88 years), comprising 11 patients with Alzheimer's disease (AD), 19 with multi-infarct dementia (MID) and 8 with probable vascular dementia (PVD). The mean age, body mass index, duration of dementia and content of triglycerides, total cholesterol and HDL-cholesterol in plasma were similar in AD and MID. The patients with PVD were older. As compared to AD, in MID and PVD the linoleic acid (LA) and other n-6 and n-3 polyunsaturated fatty acids (PUFA) were significantly lower in red cells and tended to be lower also in serum triglycerides, cholesterol esters (CHE) and phospholipids (PL), and platelets. The LA content of red cells was significantly correlated with that of serum CHE and PL, and n-6 PUFA (including arachidonic acid) of red cells. The low LA content of red cells was associated with old age, coronary heart disease and heart failure, but not with the severity of dementia.

Aged↗
PubMed1987

Snoring and dementia.

The frequency of snoring was studied in 46 patients with Alzheimer's disease (AD), 37 with multiinfarct dementia (MID), and in a random sample of 124 elderly community residents without known diseases affecting higher cortical functions. The demented patients were reported to snore twice as frequently as the control subjects (P less than 0.05). No difference in the frequency of snoring was present between the patients with AD and MID. In contrast to younger populations, snoring was not significantly associated with cardiovascular morbidity in this elderly population.

Adult↗
PubMed1987

Sleep apnea in multiinfarct dementia and Alzheimer's disease.

Sleep-related hypopneas and apneas were studied in 19 patients with multiinfarct dementia (MID), in 21 patients with Alzheimer's disease (AD), and in 26 healthy control subjects using the Static Charge-Sensitive Bed (SCSB) method. Demented patients had more apneas or hypopneas and more disturbed sleep than the control subjects. Over 10 apneas/hypopneas per hour of sleep were detected in 47.5% of the demented patients and in 19.2% of the control subjects (p less than 0.05). Restlessness comprised 46.7% of the time in bed in patients with AD and 49.6% in those with MID, but only 102.% in the control subjects (p less than 0.001, controls versus demented). The total duration of apneas and hypopneas calculated from the total sleeping time was greater than 10% in 60.0% of the demented patients and in 15.4% of the control subjects (p less than 0.001). Patients with MID tended to have more apneas/hypopneas than those with AD, and apneas/hypopneas tended to increase in direct proportion to the severity of dementia. Age had no effect on the proportion of apneas and hypopneas among demented patients or control subjects, but male controls had more apneas and hypopneas than did female controls.

Aged↗
PubMed1987

Short Portable Mental Status Questionnaire as a screening test for dementia and delirium among the elderly.

Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ) is a brief screening test for organic brain syndromes. The validity of the SPMSQ was evaluated in a random sample of 119 community residents and 282 consecutively admitted medical inpatients. The SPMSQ proved to be a sensitive and specific screening test for moderate to severe dementia both in the community and hospital. Using the cut-off point (number of errors accepted) of three errors, the sensitivity of the test was 86.2% and the specificity 99.0% among medical inpatients. The percentages in the community sample were 66.7% and 100%, respectively. The validity of the SPMSQ was not as good for delirium because of its variable clinical picture. For screening purposes lower cut-off points than previously recommended should be used: three errors for dementia and two errors for delirium. Among Finnish elderly people it was not necessary to use correction for education in the SPMSQ.

Aged↗
PubMed1987

Vascular dementia due to cardiac arrhythmias and systemic hypotension.

Among 133 consecutive patients with the clinical diagnosis of vascular dementia there were 6 patients (4.5%) in whom dementia was judged to be associated with cerebral hypoperfusion due to cardiac arrhythmias and systemic hypotension. Patients with cardio-pulmonary arrest and resuscitation were excluded from this series. Our findings suggest that cerebral hypoperfusion is not an uncommon mechanism to contribute to the evolution of vascular dementia in the elderly. Besides arrhythmias, also hypovolaemia caused by diuretics medication might have been a contributory factor to hypoperfusion. It is evident that cerebral hypoperfusion is the predominant mechanism responsible for vascular dementia in some cases. It may be a contributing factor also in many cases of multi-infarct dementia. Thus, besides dementia after cardio-pulmonary arrest, vascular dementia of the haemodynamic type as a separate clinical entity is open to discussion.

Aged↗
PubMed1987

No antibodies to HTLV-I and HIV in patients with dementia in Finland.

Patients with human immunodeficiency virus (HIV) have often progressive dementia. Human T cell lymphotropic virus Type I (HTLV-I) infection has not been reported to cause dementia. We tested antibodies to HTLV-I and HIV in serum and cerebrospinal fluid in 69 Finnish patients referred because of dementia to an outpatient department of neurology. No antibodies to HTLV-I and HIV were detected in patients with the clinical diagnosis of Alzheimer's disease, vascular dementia, secondary dementia due to a specific cause, or in cases of atypical dementia.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Suspected dementia: evaluation of 323 consecutive referrals.

A neurological outpatient department studied 323 consecutive referrals for suspected dementia: 135 (41.8%) were not demented. Of the patients 12.1% had diffuse cognitive disorder; 10.2% circumscribed memory disorder; 0.9% other circumscribed cognitive disorder, 14.2% psychiatric disorder, and 4.3% were judged to be normal. Of the nondemented, 44.1% had a potentially treatable cause for their cognitive symptoms; in 27.4% it was depression. The total of demented patients was 188 (58.2%): 38.8% had primary degenerative dementia; 37.2% vascular dementia including combined degenerative and vascular dementia; and 23.4% had a specific cause. Patients with specific cause were significantly younger than those with other causes of dementia. A potentially treatable cause was found in 10.7% of all demented patients, the most common being metabolic disorders, meningioma, hydrocephalus, subdural haematoma, and depressive pseudodementia.

Adult↗
PubMed1987

CT in the differential diagnosis between Alzheimer's disease and vascular dementia.

A prospective series of consecutively admitted patients with Alzheimer's disease (AD) (n = 68), multi-infarct dementia (MID) (n = 79) and probable vascular dementia (PVD) (n = 46) were studied by CT of the head. In MID 88.6% and in PVD 41.3% of the patients had at least one brain infarct on CT, but only one patient (1.5%) with AD. White matter low attenuation (WMLA) also differentiated MID and PVD from AD, especially among patients aged 75 years or less, and with mild or moderate dementia. In all types, brain atrophy on CT had a positive correlation with the degree of dementia. Infarcts and WMLA on CT, but not brain atrophy seem to be of differential diagnostic value between vascular and degenerative dementia.

Aged↗
PubMed1987

Serum and cerebrospinal fluid proteins and the blood-brain barrier in Alzheimer's disease and multi-infarct dementia.

Serum concentrations of IgG, IgA, IgM, haptoglobin, transferrin, prealbumin and albumin quantitated nephelometrically in 22 patients with Alzheimer's disease (AD), 29 patients with multi-infarct dementia (MID) and their age-matched controls were normal. Cerebrospinal fluid (CSF) albumin and CSF/serum ratio for albumin were higher in AD and MID patients compared to controls, but no significant differences were found between AD and MID. Patients with MID had elevated CSF IgG, IgA, IgM and prealbumin levels compared to controls and to AD. An increased CSF IgG index was found in 5 MID patients but none of the AD patients. Thus, the blood-brain barrier permeability is often increased in MID as well as in AD. There is no increased intrathecal IgG synthesis in AD but it may occur in MID.

Aged↗
PubMed1986

Neuropsychological differentiation between normal aging, Alzheimer's disease and vascular dementia.

A random sample of 182 elderly community residents and 211 demented patients were studied using the D-Test Battery based on the Luria's neuropsychological investigation method. A steady but selective cognitive impairment was observed with increasing age in normal healthy subjects. The most sensitive areas of cognition to the effects of normal aging were mnestic and conceptual functions, as well as arithmetical skills. The age-related changes could be clearly differentiated from the changes found in patients with mild degree of dementia. The test also differentiated patients with mild, moderate and severe dementia from each other on the basis of their social competence. It failed to demonstrate specific patterns of impairment and to clearly differentiate between patients with Alzheimer's disease and vascular dementia who had the same degree of cognitive decline. Further qualitative analyses are needed to improve the sensitivity and specificity of the test.

Aged↗