Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-11T08:03:19.129Z Has data issue: false hasContentIssue false
  • English
  • Français

Computed Tomography in the Elderly 2. Senile Dementia: Diagnosis and Functional Impairment

Published online by Cambridge University Press:  29 January 2018

Robin J. Jacoby  and
Raymond Levy
Robin J. Jacoby
Affiliation:
The Bethlem Royal and Maudsley Hospitals and the Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Raymond Levy
Affiliation:
The Bethlem Royal and Maudsley Hospitals and the Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Summary

Clinical, psychometric and computed tomographic (CT) data are presented on three groups of elderly subjects: 50 normals, 40 patients with senile dementia and 41 suffering from affective disorder. Demented subjects showed significantly more CT evidence of cerebral atrophy than non-demented subjects, but there was considerable overlap. Although patients with a history or clinical signs of cerebral infarction were specifically excluded, such infarcts were found more often in CT scans of the dementia subjects than in the others, particularly when the diastolic blood pressure was raised. When correlating cognitive impairment with CT changes, ventricular size emerged as more important in the dementia patients, in contrast to the controls, in whom cortical atrophy was related to lower scores on a cognitive test. Other interesting findings included an inverse relationship between cortical atrophy and paranoid delusions.

Type
Papers
Information
The British Journal of Psychiatry , Volume 136 , Issue 3 , March 1980 , pp. 256 - 269
Copyright
Copyright © Royal College of Psychiatrists, 1980 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barron, S. A., Jacobs, L. & Kinkel, W. R. (1976) Changes in size of normal lateral ventricles during aging determined by computerized tomography. Neurology, 26, 1011–13.Google Scholar
Bergmann, K. (1979) Problems of early diagnosis. Proceedings of MRC Conference on Alzheimer's Disease, Edinburgh, Scotland.Google Scholar
Bergmann, K., Proctor, S., Gilfellon, M. & Prudham, D. A psychogeriatric assessment schedule for the detection of psychiatric illness in older people living in their own homes: II. a validation study. In preparation. Google Scholar
Blessed, G., Tomlinson, B. E. & Roth, M. (1968) The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797–811.Google Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–74.Google Scholar
Constantinides, J. (1978) Is Alzheimer's disease a major form of senile dementia? Clinical, anatomical, and genetic data. In Alzheimer's Disease: Senile Dementia and Related Disorders (eds. R. Katzman, R. D. Terry and K. L. Bick), New York: Raven Press.Google Scholar
Copeland, J. R. M., Kelleher, M. J., Kellett, J. M., Gourlay, A. J., Gurland, B. J., Fleiss, J. L. & Sharps, L. (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. I. Development and reliability. Psychological Medicine, 6, 439–49.Google Scholar
Corbett, J. A. (1966) Echoencephalography in the diagnosis of presenile dementia. DPM. Dissertation, University of London. (Unpublished).Google Scholar
Fox, J. H., Topel, J. L. & Huckman, M. S. (1975) Use of computerized tomography in senile dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 38, 948–53.Google Scholar
Gado, M. & Hughes, C. (1978) Cerebral atrophy and aging. Journal of Computer Assisted Tomography, 2, 520.CrossRefGoogle Scholar
Galbraith, S., Blaiklock, C. T., Jennett, B. & Steven, J. L. (1976) The reliability of computerized transaxial tomography in diagnosing acute traumatic intracranial haematoma. British Journal of Surgery, 63, 157.Google ScholarPubMed
Garcia-Bunuel, L. (1979) Computerized tomography and subdural haematomas. Lancet, i, 110.Google Scholar
Gosling, R. H. (1955) The association of dementia with radiologically demonstrated cerebral atrophy. Journal of Neurology, Neurosurgery and Psychiatry, 18, 129–33.Google Scholar
Gurland, B. J., Fleiss, J. L., Goldberg, K., Sharpe, L., Copeland, J. R. M., Kelleher, M. J. & Kellett, J. M. (1976) A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule. II. A factor analysis. Psychological Medicine, 6, 451–9.Google Scholar
Gustafson, L. & Risberg, J. (1974) Regional cerebral blood flow related to psychiatric symptoms in dementia with onset in the presenile period. Acta Psychiatrica Scandinavica, 50, 516–38.Google Scholar
Gyldensted, C. (1977) Measurements of the normal ventricular system and hemispheric sulci of 100 adults with computed tomography. Neuroradiology, 14, 183–92.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.Google Scholar
Hendrickson, E., Levy, R. & Post, F. (1979) Averaged evoked responses in relation to cognitive and affective state of elderly psychiatric patients. British Journal of Psychiatry, 134, 494–501.Google Scholar
Haug, G. (1977) Age and sex dependence of the size of normal ventricles on computed tomography. Neuroradiology, 14, 201–4.Google Scholar
Hodkinson, H. M. (1973) Mental impairment in the elderly. Journal of the Royal College of Physicians of London, 7, 305–17.Google ScholarPubMed
Huckman, M. S., Fox, J. & Topel, J. (1975) The validity of criteria for the evaluation of cerebral atrophy by computed tomography. Radiology, 116, 85–92.Google Scholar
Jacobs, L., Kinkel, W. R., Painter, F., Murawski, J. & Heffner, R. R. (1978) Computerized tomography in dementia with special reference to changes in size of normal ventricles during aging and normal pressure hydrocephalus. In Alzheimer's Disease: Senile Dementia and Related Disorders (eds. R. Katzman, R. D. Terry and K. L. Bick), New York: Raven Press.Google Scholar
Jacoby, R. J., Levy, R. & Dawson, J. M. (1980) Computed tomography in the elderly: 1. The normal population. British Journal of Psychiatry, 136, 249–55.Google Scholar
Jacoby, R. J., Levy, R. (1980) Computed tomography in the elderly: 3. Affective disorder. British Journal of Psychiatry, 136, 270–75.Google Scholar
Kendrick, D. C. (1965) Speed and learning in the diagnosis of diffuse brain damage in elderly subjects: a Bayesian statistical approach. British Journal of Social and Clinical Psychology, 4, 141–8.Google Scholar
Kiev, A., Chapman, L. F., Guthrie, T. C. & Wolff, H. G. (1962) The highest integrative functions and diffuse cerebral atrophy. Neurology, 12, 385–93.CrossRefGoogle ScholarPubMed
Kraft, E., Schillinger, A., Finby, N. & Halperin, M. M. (1965) Routine skull radiography in a neuropsychiatric hospital. American Journal of Psychiatry, 121, 1011–12.Google Scholar
McDonald, C. (1969) Clinical heterogeneity in senile dementia. British Journal of Psychiatry, 115, 267–71.Google Scholar
Mann, A. H. (1973) Cortical atrophy and air encephalography: a clinical and radiological study. Psychological Medicine, 3, 374–8.Google Scholar
McCormick, W. O. (1962) A study of the relationship between dementia and radiologically diagnosed cerebral atrophy in elderly patients. DPM Dissertation, University of London. (Unpublished).Google Scholar
Menzer, L., Sabin, T. & Mark, V. H. (1975) Computerized axial tomography: use in the diagnosis of dementia. Journal of the American Medical Association, 234, 754–7.Google Scholar
Nielsen, R., Petersen, O., Thygesen, P. & Willanger, R. (1966a) Encephalographic ventricular atrophy: relationships between size of ventricular system and intellectual impairment. Acta Radiologica Diagnosis, 4, 240–56.Google Scholar
Nielsen, R., Petersen, O., Thygesen, P. & Willanger, R. (1966b) Encephalographic cortical atrophy: relationships to ventricular atrophy and intellectual impairment. Acta Radiologica Diagnosis, 4, 437–48.Google ScholarPubMed
Post, F. (1975) Dementia, depression and pseudodementia. In Psychiatric Aspects of Neurologic Disease (eds. D. F. Benson and D. Blumer). New York: Grune and Stratton.Google Scholar
Roberts, M. A. & Caird, F. I. (1976) Computerized tomography and intellectual impairment in the elderly. Journal of Neurology, Neurosurgery and Psychiatry, 39, 986–9.CrossRefGoogle ScholarPubMed
Roth, M. (1971) Classification and aetiology in mental disorders of old age: some recent developments. In Recent Developments in Psychogeriatrics (eds. D. W. K. Kay and A. Walk). British Journal of Psychiatry, Special Publication No. 6.Google Scholar
Slater, E. & Roth, M. (1969) Clinical Psychiatry, p 615. London: Baillière, Tindall and Cassell.Google Scholar
Waggoner, R. W. & Bagchi, B. K. (1954) Initial masking of organic brain changes by psychic symptoms. American Journal of Psychiatry, 110, 904–10.Google Scholar
Wechsler, D. (1955) The Wechsler Manual. New York: The Psychological Corporation.Google Scholar
Wells, C. E. & Duncan, G. W. (1977) Danger of over-reliance on computerized cranial tomography. American Journal of Psychiatry, 134, 811–13.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.