Biomedical subjects

V O Emery

Publications and source records attributed to V O Emery.

5 recordsLinked to original sources

PubMed2000

Interface between vascular dementia and Alzheimer syndrome. Nosologic redefinition.

Vascular dementia is redefined so as to include noninfarct vascular dementia: vascular dementia caused by underlying vascular factors other than cerebral infarction. Data are presented that bring into focus the interface between vascular dementia and Alzheimer syndrome, and the ambiguous transition between multifocality and diffuse or generalized disease. By cross-cutting both stroke and nonstroke vascular groups, arteriosclerosis, abnormal blood pressure, abnormal electrocardiogram, and other vascular factors are implicated in the distal causality of both infarct and noninfarct vascular dementia.

Aged↗

PubMed2000

Language impairment in dementia of the Alzheimer type: a hierarchical decline?

OBJECTIVE: Progressive memory impairment is the primary cognitive feature of Alzheimer's disease. Systematic attention to progressive language impairment is under-appreciated. The purpose of this article is to apply the semiotic language framework to organize the disparate findings on language impairment in DAT. METHOD: The semiotic system is hierarchical, going from simple to more complex units of language, with the hierarchical ranks of phonology, morphology, syntax, semantics. This language hierarchy is used as an organizing tool to provide a context for the discrete data on language decline in DAT. Studies relating to language impairment in DAT were identified through an exhaustive computerized search (Medline and Psych Info Database) of available literature spanning the last forty years in which 615 references were examined. Papers were selected for review if reference were made to any one or more of the language parameters of phonology, morphology, syntax, semantics, or to any components or indicators of these parameters, such as sound production, naming, grammar, sentence processing, verbal comprehension in Alzheimer patients. RESULTS: There appears to be an overall relation between language decline and complexity of language both across and within the hierarchical ranks. There also appears to be an associated negative relation between sequence in language development and language decline. Language forms learned last in the sequence of language development are the most complex and appear to be first to deteriorate. CONCLUSIONS: The decline of language in DAT appears to be hierarchical in nature. Further understanding of this hierarchical language decline depends in part on nosologic clarification and subtyping of DAT.

Aging↗

PubMed1997

Depressive dementia: a "transitional dementia"?

This review comprises a historical, clinical, and empirical examination of the dementia spectrum of depression. The primary focus of the article is to evaluate the usual dichotomy between depressive dementia as functional-reversible and degenerative dementia as organic-irreversible. It is proposed that depression, cognitive impairment, and degenerative dementia be viewed as intersecting continua. Five prototypical groups are defined along these continua: (1) major depression without depressive dementia, (2) depressive dementia, (3) degenerative dementia without depression, (4) depression of degenerative dementia, and (5) random co-occurrence of depression and degenerative dementia. The data suggest that a subset of cases of major depression without dementia appear to evolve into depressive dementia, and in turn, depressive dementia may constitute a risk factor for degenerative dementia. Depressive dementia and degenerative dementia can sometimes represent two different points of organic deterioration and severity in a long-term, multiphasic disease course; depressive dementia sometimes appears to be a transitional stage or phase in a disease progression from depression without dementia to a degenerative dementia. The concept of "transitional dementia" is introduced in a heuristic and preliminary attempt to accommodate the nosologic entity of depressive dementia.

Aged↗

PubMed1996

1995 IPA/Bayer Research Awards in Psychogeriatrics. Reclassification of the vascular dementias: comparisons of infarct and noninfarct vascular dementias.

This article focuses on some of the long-standing problems that exist in the classification of the vascular dementias. To clarify the definition of vascular dementia, mental status and other cognitive processes were investigated in 12 patients with a single cerebral infarct (mean age, 74.8 years), 17 patients with multiple cerebral infarcts (mean age, 71.4 years), 21 vascular patients with no cerebral infarcts (mean age, 76.9 years), and 16 demographically equivalent normal elderly persons (mean age, 70.4 years). The following null hypotheses /hypotheses were tested: (a) The cognitive impairment of single-infarct, multiple-infarct, and noninfarct vascular patients is not/is significantly greater than and outside the range of that in normal aging, and (b) there are/are not significant differences between single-infarct, multiple-infarct, and noninfarct vascular patients on mental status and other cognitive measures. Measures used included the Mini-Mental State Examination, Dementia Rating Scale, Western Aphasia Battery, and Boston Naming Test. Results indicate that vascular disorders involve a decrement in mental status and other cognitive functions that is significantly greater than the age-associated cognitive impairment of normal aging. Also, results from the study indicate that there were no robust, reliable significant differences between single-infarct, multiple-infarct, and noninfarct patients. The validity of the distinction of focal versus generalized or diffuse cerebral lesions is questioned. The nosologic entity of noninfarct vascular dementia is introduced. The future nosology of vascular dementia should provide for noninfarct vascular dementia, defined as vascular dementia caused by underlying vascular mechanisms other than cerebral infarction.

Aged↗

PubMed1992

Update on the dementia spectrum of depression.

OBJECTIVE: The primary focus of this review is to examine the usual dichotomy between depressive dementia as functional and reversible and degenerative dementia as organic and irreversible. METHOD: The authors propose viewing depression, cognitive impairment, and degenerative dementia as intersecting continua. They define five prototypical groups along these continua: 1) major depression without depressive dementia, 2) depressive dementia, 3) degenerative dementia without depression, 4) depression of degenerative dementia, and 5) independent co-occurrence of degenerative dementia and depression. Clinical, neuropsychological, and neurobiological studies comparing these groupings were identified by a computerized literature search covering the past 20 years. References were selected for review if they compared at least two groups. Degenerative dementia was limited to the Alzheimer type. RESULTS: No studies clearly included all five of the prototypical groups. There are methodological problems with each type of research reviewed, but the consensus of the research is that severe cognitive impairment of depression is associated with a variety of organic abnormalities. Depending on the length of follow-up, depressive dementia may not be as reversible as previously thought. CONCLUSIONS: The continuum viewpoint encourages longitudinal clinical follow-up for early detection and alleviation of incipient depressive and dementing symptoms. Hypotheses of overlapping pathophysiological mechanisms rather than differential diagnosis become an important research focus. The authors discuss three different types of relationships for future research: 1) interactions, 2) consequences of disease or treatment, and 3) necessary but not sufficient pathophysiology.

Alzheimer Disease↗