Biomedical subjects

R W Ponds

Publications and source records attributed to R W Ponds.

At least 19 recordsLinked to original sources

PubMed2004

The seven minute screen: a neurocognitive screening test highly sensitive to various types of dementia.

BACKGROUND: The seven minute screen (7MS) is a compilation of the temporal orientation test, enhanced cued recall, clock drawing, and verbal fluency. It has been shown to be useful for detecting Alzheimer's disease in a population of patients with memory complaints. OBJECTIVE: To assess the predictive validity of the 7MS for various types of dementia, and the influence of depression and other psychiatric conditions on 7MS scores. SETTING: Multicentre: secondary referral sites across the Netherlands. SUBJECTS: 542 patients with various types of dementia or depression, together with 45 healthy controls. RESULTS: Alzheimer's disease was diagnosed in 177 patients, other types of dementia in 164. The sensitivity of the 7MS for Alzheimer's disease was 92.9% with a specificity of 93.5%. For other types of dementia the sensitivity was 89.4% and the specificity 93.5%. Cognitive abnormalities were found in 71% of the patients with depression (n = 31). The mean (SD) duration of administration of the 7MS was 12.4 (4.6) minutes, range 8 to 22, depending on dementia severity. CONCLUSIONS: The 7MS is a useful screening tool for discriminating patients with dementia from cognitively intact patients. This not only applies to Alzheimer's disease but also to other types of dementia. Specificity with respect to depression was lower for the 7MS than for the MMSE.

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PubMed2001

Diagnosis of preclinical Alzheimer's disease in a clinical setting.

INTRODUCTION: The aim of the study was to investigate whether the preclinical stage of Alzheimer's disease (AD) can be diagnosed in a clinical setting. To this end we investigated whether subjects with preclinical AD could be differentiated from subjects with nonprogressive mild cognitive impairment and from subjects with very mild AD-type dementia. METHODS: Twenty-three subjects with preclinical AD, 44 subjects with nonprogressive mild cognitive impairment, and 25 subjects with very mild AD-type dementia were selected from a memory clinic population. Variables that were used to differentiate the groups were demographic variables, the Mini-Mental State Examination score, performance on cognitive tests, measures of functional impairment, and measures of noncognitive symptomatology. RESULTS: Age and the scores for the delayed recall task could best discriminate between subjects with preclinical AD and subjects with nonprogressive mild cognitive impairment. The overall accuracy was 87%. The score on the Global Deterioration Scale and a measure of intelligence could best discriminate between subjects with preclinical AD and subjects with very mild AD-type dementia. The overall accuracy was 85%. CONCLUSIONS: Subjects with preclinical AD can be distinguished from subjects with nonprogressive mild cognitive impairment and from subjects with very mild AD-type dementia. This means that preclinical AD is a diagnostic entity for which clinical criteria should be developed.

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PubMed2001

The influence of soy-derived phosphatidylserine on cognition in age-associated memory impairment.

Phosphatidylserine (PS) is a phospholipid widely sold as a nutritional supplement. PS has been claimed to enhance neuronal membrane function and hence cognitive function, especially in the elderly. We report the results of a clinical trial of soybean-derived PS (S-PS) in aging subjects with memory complaints. Subjects were 120 elderly (> 57 years) of both sexes who fulfilled the more stringent criteria for age-associated memory impairment (AAMI); some also fulfilled the criteria for age-associated cognitive decline. Subjects were allocated at random to one of the three treatment groups: placebo, 300mg S-PS daily, or 600mg S-PS daily. Assessments were carried out at baseline, after 6 and 12 weeks of treatment, and after a wash-out period of 3 weeks. Tests of learning and memory, choice reaction time, planning and attentional functions were administered at each assessment. Delayed recall and recognition of a previously learned word list comprised the primary outcome measures. No significant differences were found in any of the outcome variables between the treatment groups. There were also no significant interactions between treatment and 'severity of memory complaints'. In conclusion, a daily supplement of S-PS does not affect memory or other cognitive functions in older individuals with memory complaints.

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PubMed2000

Pesticide exposure and risk of mild cognitive dysfunction.

Little is known about the adverse effects of substances, such as pesticides and metals, on the development of mild cognitive dysfunction (MCD). Cross-sectional and prospective data from the Maastricht Aging Study were used to find out the potential neurotoxicity of particular substances. Exposure to pesticides, for example by arable farmers and gardeners, was associated with increased risks of MCD. Exposure to metals and organic solvents was not associated with MCD. Our findings might reflect subtle changes in brain function among people exposed to pesticides.

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PubMed2000

Course of objective memory impairment in non-demented subjects attending a memory clinic and predictors of outcome.

The aim of the study was to investigate the course of objective memory impairment in non-demented subjects who attended a memory clinic and to test predictors of outcome. Non-demented subjects (N=74) were included when they were older than 40 years and had a baseline score on the delayed recall of a word learning test below the tenth percentile. Subjects with memory impairment due to known somatic or neurological causes were excluded. The subjects were reassessed after 2 and 5 years. At the 5-year follow-up, 42% of the subjects had no memory impairment, 19% of the subjects had memory impairment without dementia, and 39% of the subjects had Alzheimer type dementia (AD). Predictors at baseline of reversible memory impairment in a multivariate analysis were age, scores on the MMSE and delayed recall, and the degree of functional impairment. Predictors at baseline of AD in a multivariate analysis were age and the score on the MMSE. The apolipoprotein E genotype and the presence of depression at baseline were not predictors of outcome. The positive predictive value was 72% for reversible memory impairment and 81% for AD. Memory impairment is often reversible and therefore its presence alone is not sufficient to consider subjects as preclinically demented. Predictive accuracy can be increased by including simple measures such as age, the scores on the MMSE and delayed recall, and the degree of functional impairment.

Age Factors↗

PubMed2000

Distinction between preclinical Alzheimer's disease and depression.

OBJECTIVE: To assess the prevalence of depression in subjects with preclinical Alzheimer's disease (AD) and to investigate the possibility of differentiating subjects with preclinical AD and depression from subjects with depression-related cognitive impairment. DESIGN: A prospective, observational cohort study. SETTING: An outpatient memory clinic of a university-affiliated hospital. PARTICIPANTS: Nondemented subjects with cognitive impairment older than 55 years (n = 111) without neurological or somatic causes for the cognitive impairment. MEASUREMENTS: At baseline, data were collected on patient characteristics, the severity of depression, and cognitive functioning. The course of the cognitive impairment and the presence of dementia were assessed after 2 and 5 years. RESULTS: Twenty-five subjects had preclinical dementia with Alzheimer's type dementia at follow-up. Sixty percent of these subjects (n = 15) were depressed at baseline. Subjects with depression and preclinical AD had at baseline a poorer performance on the cognitive tasks and were older than the subjects with depression-related cognitive impairment. Logistic regression with backward step selection selected age and memory performance as the best predictors for Alzheimer's type dementia in the depressed subjects. The specificity of these predictors for the diagnosis of future Alzheimer's type dementia in depressed subjects was 94%, sensitivity was 90%, positive predictive value was 90%, and negative predictive value was 94%. CONCLUSIONS: Depression is common in preclinical AD. Depressed subjects with preclinical AD can be accurately differentiated from subjects with depression-related cognitive impairment by age and the severity of the memory impairment. Research that aims to investigate preclinical AD should not exclude a priori subjects with depression inasmuch as preclinical AD is often accompanied by depression.

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PubMed1999

How ageing and social factors affect memory.

OBJECTIVES: To explore the relationships between lifestyle and memory, and determine whether social factors influence memory. METHODS: the relationship between memory and lifestyle was examined in 497 adults aged 25-80 years, using the Mectamemory in Adulthood questionnaire. We asked about sports activity and perceived activity, participation in voluntary organizations and social contacts. RESULTS: Activity and frequent contact with friends and family were related to higher memory capacity scores. Those with higher capacity scores were also younger, had better health and a stronger internal locus of control. In contrast, people with higher anxiety scores had more symptoms and less education, and were more externally oriented. CONCLUSIONS: people who consider themselves socially and physically active also consider their memory capacity to be good and are less anxious about their memory than less socially and physically active people. Perceived memory change appears to be predominantly influenced by ageing, whereas memory capacity and memory anxiety are more influenced by social factors.

Adult↗

PubMed1999

Lithium induced cognitive side-effects in bipolar disorder: a qualitative analysis and implications for daily practice.

Qualitative analysis of the literature on cognitive side-effects of lithium in patients with a bipolar disorder identified four of 17 studies that fulfilled criteria of adequate methodological quality. Analysis of these four studies showed that lithium had a negative effect on memory and speed of information processing, often without subjective complaints or awareness of mental slowness. The consequences of these findings for daily practice are discussed, in particular with respect to driving performance. When neurocognitive complaints or deficits are present, lithium plasma level, thyroid functions and degree of mood disturbance should be assessed. In cases where all these parameters are within normal limits and neurocognitive complaints still persist, dose reduction of lithium, thyroid hormone addition, prescription of a slow release preparation or replacement of lithium by another moodstabiliser should be considered. Guidelines are suggested with respect to further neuropsychological screening.

Antimanic Agents↗

PubMed1998

Subjective forgetfulness in a normal Dutch population: possibilities for health education and other interventions.

Many, especially elderly people, are worried about their diminishing memory. In order to be able to improve health education activities about forgetfulness and aging processes, nearly 2000 healthy Dutch people, aged 25-85 years, participated in a postal survey into the determinants of subjective forgetfulness. As expected, there was a systematic increase in the prevalence of forgetfulness with age. The relatively high prevalence of forgetfulness in the young (29%) and middle-aged groups (34%) was unexpected. Besides age, the occurrence of dementia in a close relative appeared to be a strong predictor of people's subjective forgetfulness. Furthermore, people who felt more in control of their memory functioning reported less forgetfulness. Younger people ascribed their forgetfulness mostly to external causes (stress, concentration) and older people to internal causes (age, retardation). Eleven percent of all forgetful people were interested in an intervention for their memory complaints. In this group, education (37%), memory training (29%), and medication (12%) were the preferred interventions. No differences were found between older and younger respondents.

Adult↗

PubMed1998

[The Maastricht aging study (MAAS). The longitudinal perspective of cognitive aging].

The Maastricht Aging Study (MAAS) was designed to specify the usual and pathological aging of cognitive function. In short, the main questions of MAAS are: who deteriorates when in which aspects of cognitive function, and what biomedical or psychosocial factors can be identified that may act as mediators in this process? The study comprises four independent panel studies in which a group of 1,900 initially healthy individuals are followed for a period of 12 years with respect to health characteristics and neurocognitive status. For this purpose a sample was drawn from a patient register of collaborating general practitioners, stratified by age (range 24 to 81 years), sex and general ability level. Rationale and design of MAAS are discussed and some findings from the cross-sectional baseline measurement are summarized: general aspects of memory and attention in aging, cognitive functioning after brain trauma and general anesthesia, physical condition (fitness, morbidity and vascular risk factors, such as blood pressure) as predictors of cognitive function, and finally cognitive complaints and metamemory.

Adult↗

PubMed1997

Effect of test duration on age-related differences in Stroop interference.

The effect of test duration on age-related differences in Stroop interference was assessed in a large cross-sectional study involving 429 healthy subjects in four age groups (25-35 years, 40-50 years, 55-65 years, 70-80 years). The results show a clear effect of test duration on Stroop interference. The Stroop Color Word Test was run in two parts. The young group performed the first part relatively rapidly but became slower in the second part, whereas the old group showed the reverse effect. The two middle-aged groups did not show differences between the first and second parts of the test. The results are interpreted in terms of a deficit in response inhibition by a controlled processing strategy. A psychological interpretation of the study findings in terms of increased cautiousness appears less probable. The first part of the test, that is, an abridged version of the test, may prove superior to the regular version for both clinical and research purposes.

Adult↗

PubMed1997

Prevalence and covariates of subjective forgetfulness in a normal population in The Netherlands.

In this study we examined the prevalence and covariates of forgetfulness in a large sample of almost 2,000 subjects in the age range twenty-four to eighty-six years. Nearly 40 percent of the participants considered themselves to be forgetful. There was a systematic increase in the prevalence of forgetfulness with age, from 29 percent in the young age group to 52 percent in the oldest age group. Forgetfulness was not considered to be a serious problem in terms of perceived hindrance and worry by most subjects, independent of their age. Age, depression, and subjective health (especially complaints about vitality) acted as covariates of forgetfulness. Gender and education had no effect on the prevalence of forgetfulness. The younger adults ascribed their forgetfulness more to potentially reversible and manageable memory-extrinsic causes such as tension and emotional problems, whereas the older adults mentioned less manageable and more or less irreversible memory-intrinsic causes such as aging more often.

Adult↗

PubMed1996

The Abridged Dutch Metamemory in Adulthood (MIA) Questionnaire: structure and effects of age, sex, and education.

This study presents data on the factor structure, reliability, and discriminant validity of the Metamemory in Adulthood (MIA) questionnaire in a Dutch sample of 1,899 normal and healthy participants aged 24 to 86 years. The factor structure of the Dutch MIA corresponded with that of the original MIA. The Strategy scale could be divided into two subscales: External and Internal Memory Strategies. The number of items on the MIA could be reduced by 34% without loss of the factor structure or lowering of the internal consistency of the subscales. Data on the relation of the abridged MIA with age, sex, education, depression, anxiety, and subjective health are presented. The study supports the cross-national use of the MIA as a research and clinical instrument for the evaluation of subjective memory functioning.

Adult↗

PubMed1995

Depression, insight, and personality changes in Alzheimer's disease and vascular dementia.

Although it is generally believed that depression, retained insight, and preserved personality occur more frequently in vascular dementia than in Alzheimer's disease, there is little empiric evidence for this presumption. Most studies on this subject have been carried out with severely demented inpatients, and confounding factors such as age, sex, and severity of dementia have not been sufficiently taken into account. We compared 48 patients with relatively mild vascular dementia with 48 patients with Alzheimer's disease, matched for age, sex, and stage of dementia, to investigate if depression, lack of insight, and personality changes were related to the cause of dementia. The two groups did not differ regarding the incidence of major depression, the mean depression score, the awareness score, or the sum of scores on the items of the Blessed Dementia Scale concerning personality changes. We conclude that depression, lack of insight, and personality changes do not favor an etiology of vascular dementia over that of Alzheimer's disease. The present findings underscore the notion that the severity of the dementia should be considered in studies on the differences between vascular dementia and Alzheimer's disease.

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PubMed1994

Public education about normal forgetfulness and dementia: importance and effects.

In the Netherlands considerable attention has been given to dementia, but hardly any is paid to normal forgetfulness. Two information meetings about the differences between normal forgetfulness and dementia were organized in order to meet current information needs. Evaluation of those meetings gave more insight into the characteristics of people who are worried about their diminishing memory and provided the opportunity of measuring changes in knowledge and anxiety. Almost 50% of the 450 participants indicated that they were worried about their memory; 66% of these people reported being more or less reassured afterwards. Although the level of knowledge increased, no correlation was found between increased knowledge and decreased anxiety. Because of people's anxiety about possible dementia, it is important to provide the general public with more information about this subject. More research, with a control group, is necessary to draw conclusions about the effectiveness of health education in this area.

Adult↗

PubMed1993

[Psychiatric disorders in patients of a memory outpatient clinic].

OBJECTIVE: To determine whether psychiatric conditions other than depression are relevant in elder patients with memory disturbances. METHODS: 430 consecutive outpatients (242 males, 188 females; mean age 61.7 years) who visited the Maastricht Memory Clinic were examined, according to a standardised diagnostic procedure, including somatic, neurological, psychiatric and neuropsychological examination. Psychiatric disorders were diagnosed according to DSM-III(-R) criteria. RESULTS: Of 152 patients with dementia, 34 had a secondary depressive syndrome, 19 another secondary psychiatric disorder. Of the 37 patients with a psycho-organic disorder other than dementia, 16 had an organic mood disorder. Of the other 241 patients, 152 had 159 primary psychiatric diagnoses: mood disorders in 100 cases and other psychiatric disorders in 59 cases, especially adjustment disorders, anxiety disorders and personality disorders. Together, only 60% percent of all primary or secondary psychiatric disorders were mood disorders. Various ways in which organic substrate, cognitive problems and psychopathology can be interrelated are discussed. CONCLUSION: Although affective disorders were the most frequent psychiatric disorders, several other psychiatric conditions were related to memory disturbances as well. Psychiatric assessment in patients with memory complaints should not be restricted to the diagnosis of depressive symptoms.

Adolescent↗

PubMed1993

Diagnosing dementia: a comparison between a monodisciplinary and a multidisciplinary approach.

Discrepancies were examined in diagnostic outcome between a monodisciplinary approach and a multidisciplinary, criteria-based approach in patients referred to a university memory clinic. Of 278 patients not fulfilling dementia criteria, 19 had been previously diagnosed as demented (specificity: 0.93). In 60 of 152 demented patients, dementia had not been diagnosed before (sensitivity: 0.61). Underreporting was frequent for mildly demented patients and for patients with coexisting depressive symptoms. In patients referred by psychiatrists, sensitivity rates for dementia and Alzheimer's disease were low; in patients referred by neurologists, depression often went unreported. Results underscore the need for more frequent use of integrated multidisciplinary services for cognitively disturbed patients.

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PubMed1993

[Public information on normal forgetfulness and dementia: effectiveness of a systematically developed information pamphlet].

Previous research revealed that many elderly people are worried about their memory and are afraid of falling victim to dementia. An information brochure was developed in 1991 for this target group. After reading the brochure, 63% of all respondents who were worried about dementia beforehand (n = 307), said that their anxiety had decreased or disappeared. Approximately 3% of the total group of 400 respondents became more worried. A cognitive test battery was used to determine whether people's increased or decreased anxiety was justifiable. This test battery gave an indication of the severity of cognitive problems. A sample of 104 people was tested. Thirty subjects achieved a low test score and sixteen of them were inappropriately reassured by the brochure. Approximately 64% of fifty-four subjects who performed well on cognitive test and were worried about dementia beforehand, were rightly reassured, but the other 36% were (still) unnecessarily worried. The occurrence of dementia in a close relative covaried with worries about possible dementia in people with good test results. In conclusion, it appeared that an information brochure about normal forgetfulness and dementia may reduce the anxiety for dementia.

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