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[Combined therapies in family practice and hospitals. A controlled clinical study of a population of 162 patients with criteria of age-related memory disorders].

OBJECTIVES: To assess the combination of drug and cognitive therapy on age-associated memory impairment (AAMI). PATIENTS AND METHODS: A double-blind randomized trial was performed involving 162 patients with age-associated memory impairment selected and followed by their general practitioners. Two intervention methods-a drug and a cognitive therapy-were assessed in combination. Three randomized parallel groups of 54 patients each, aged 55 years and over, were followed and treated for 3 months. After a placebo washout period of 10 days, one group received 2.4 g of piracetam, another group, 4.8 g and the third, a placebo. RESULTS: A total of 135 patients, 45 in each group, completed the study. Combined therapy was most effective in patients whose baseline performance on memory tests was lowest. The best results were observed with piracetam combined with memory training. This result confirmed by the global impression of the principal investigator was in agreement with findings of previous double-blind placebo-controlled trials assessing the combined effect of drug treatment and memory training. CONCLUSION: This result confirmed by the global impression of the principal investigator was in agreement with findings of previous double-blind placebo-controlled trials assessing the combined effect of drug treatment and memory training.

Aged

Memory disorders as a function of traumatic brain injury. Word completion, recall of words and actions.

The memory performance of a group with traumatic brain injury and a matched control group was assessed using the following methods (a) word completion, (b) immediate free, final free and final cued recall of words and (c) immediate free and final free recall of subject-performed tasks (SPTs) and SPTs without motor action (SPTs-WA). The brain-injured (BI) group was significantly inferior relative to the control group in all recall tests except immediate free recall of words. No difference was revealed in the word completion test. The BI-group benefitted less by cues presented either at retrieval (final cued recall of words) or at the time of encoding already built-in in the stimulus (SPTs and SPTs-WA). The results were discussed in terms of the neuropathological background of the patients in the BI-group suggesting that frontal dysfunction could play a critical role. When comparing the tests within the BI-group, however, the performance was better when cues were present and especially so for long-term memory. Motor activity also facilitated long-term memory. Finally, an attempt was made to specify conditions for guidance in the construction of training programmes.

Adult

[Free radical mechanisms of memory disorders of toxic origin and experimental therapy of the condition].

Influence of the pesticides deltametrin and dichlophos on memory processes and activity of the antioxidative enzymes superoxide dismutase (SOD) and catalase in the brain and blood of female rats was studied. Xenobiotics disturbed processes of formation and storage of signs of memory, which were tested in the conditional reaction of passive avoidance and in the conditional reaction of active avoidance; they also lowered SOD activity (but not catalase) in the brain (deltametrin by 25%, dichlophos by 21%) 3 h after their injection to the animals. Indices of SOD activity and blood catalase didn't change. SOD inhibition is suggested to be a result of the action of biotransformation product of deltametrin and dichlophos molecules on it, since in in vitro experiments pesticides don't exert influence on the inhibition kinetics of epinephrine autooxidation by brain homogenates. Prophylactic use of alpha-tocopherol or unithiol optimizes the processes of learning and memory in rats, intoxicated with these toxicants; a more marked antiamnestic, effect is observed in the combined injection of these preparations.

Animals

Cued recall and the nature of the memory disorder in dementia.

The study investigated the retrieval deficit hypothesis of forgetting in senile dementia, using a cued recall technique. Memory for lists of words was tested with either no cues given at the time of recall, or alternatively by cueing the patient either with the word's first letter or its semantic category. Results do not support a retrieval deficit explanation of forgetting in dementia, but instead suggest the possibility of a processing deficit at the acquisition stage.

Aged

A brief survey of the management of memory disorders in rehabilitation units in Britain.

A survey of rehabilitation units and other hospitals and departments involved in the management of memory dysfunction revealed considerable variation in approaches to treatment and in assessment techniques. A very few respondents with a special interest in memory dysfunction were used wide ranges of tests, training procedures and aids. Other respondents were concerned about the lack of training and in the management of memory problems and the lack of guidance as to what techniques should be used. A pragmatic approach to helping patients with particular problems is contrasted with general memory training and the assumptions underlying such training are discussed.

Brain Diseases

A clinical trial with desglycinamide arginine vasopressin for the treatment of memory disorders in man.

In a double-blind cross-over trial the memory effect of the neuropeptide desglycinamide arginine vasopressin (DGAVP) was selected because of its well-documented facilitatory effects on memory components in rodents. Patients with stabilized or progressive amnesic disorders (Korsakoff disease, early stages of Alzheimer dementia, head injuries and other central nervous system diseases) did not respond to the drug. Factors possibly explaining the discrepancy with animal research are discussed.

Adult

The clinical management of HIV-related dementia and other memory disorders in the residential drug treatment environment.

Human immunodeficiency virus (HIV)-related dementia and other memory and attention disorders are described in terms of etiology, incidence, and symptoms. Assessment for cognitive impairment includes basic screening (examples are given), or a thorough neuropsychological evaluation. Implications for treatment within the residential drug treatment environment include: (a) providing accurate information to staff and residents; (b) identifying residents' anticipatory anxiety; (c) supportive counseling of residents; (d) coaching residents in the use of coping strategies; (e) creating environmental support; and (f) frequent reassessment of treatment goals, including the appropriateness of independent living. Helpful concrete suggestions are listed.

AIDS Dementia Complex