In the diagnosis, treatment, and care of dementia patients in the senile stage, comprehensive evaluation of ability in daily life and mental function is needed. Using a simple behavioral rating scale for the mental states (NM scale) and activities of daily living (N-ADL) of the elderly, we evaluated 250 elderly subjects. According to the NM scale, the scores for subjects in whom the severity was clinically diagnosed were as follows: normal, 50–48; borderline, 47–43; mild dementia, 42–31; moderate dementia, 30–17; and severe dementia, 16–0. Screening for dementia and determining its severity were readily accomplished using the NM scale, and basic activities in the daily life of the elderly could be evaluated effectively using the N-ADL. There was a significant correlation (r=0.863) between the Hasegawa dementia scale and the NM scale (p<0.001), a significant correlation (r=−0.947) between intellectual function scores of the GBS scale and the NM scale, and a significant correlation (r=0.944) between motor function score of the GBS scale and the N-ADL score. Evaluations of daily life activities can be made not only by psychiatrists and clinical psychologists, but by nonspecialists as well, because they are based on data obtained by observation of daily life behaviors; thus, assessment is appropriate both in clinical settings and in places of living.

In an attempt to clarify the nature of histaminergic neuromodulation of the vasopressinergic system, several studies under different experimental paradigms were carried out. L-Histidine loads (8 mmol/kg, i.p.) induced a marked increase in histamine (HA) in the anterior (AHR) and posterior (PHR) hypothalamic regions, the median eminence (ME) and adenohypophysis (Ah) with no apparent effect on the concentration of HA in the neurohypophysis (Nh), as measured by high-performance liquid chromatography. These findings correlated with decreases in vasopressin (VP) levels in the AHR and ME, accompanied by increases of the neuropeptide in the PHR and Ah. Intraperitoneal injections of HA (6 µmol/kg), resulted in a significant (p < 0.005) rise in VP levels in the PHR, ME and Ah. HA induced an elevation of VP in the prefrontal cortex (PFC) from 6.23 ± 2.02 to 43 ± 4.05 µU/mg, as well as a 60% reduction in neurohypophyseal VP. These HA-induced VP responses were abolished by both mepyramine (3 µmol/kg) and famotidine (4 µmol/kg) in the PHR and PFC. Mepyramine suppressed the HA-induced VP response in the Ah and enhanced it in the Nh, while famotidine did the opposite. When alpha-fluoromethylhistidine (FMH), an irreversible inhibitor of histidine decarboxylase, was administered at doses of 100 mg/kg/day (i.p.), hypothalamic HA levels fell by 40–45% after 1 h, by 50% after 3 h, and by 65–80% after 24 h in adrenalectomized rats. In the same conditions, but after a week of treatment with FMH, the VP response to adrenalectomy was clearly impaired. These results seem to demonstrate that the physiological levels of neuronal HA are indispensable for the normal functioning of the neuroendocrine system. In this context, preliminary pharmacological evidence showed that histaminergic neuromodulation of the vasopressinergic system is mediated through H₁ receptors in the Ah, H₁ receptors in the ME and Nh, and both H₁ and H₂ receptors in the PFC and hypothalamus.

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Abstract. To clarify the functional state of the somatotropinergic system at the hypothalamo-hypophyseal level in senile dementia of the Alzheimer type, the GHRH test was performed in three groups of subjects: a) healthy elderly subjects; b) early onset senile dementia patients; and c) late onset senile dementia patients. Intravenous administration of GHRH(1–44)NH2 (100 μg) elicited a marked plasma GH response with a maximum peak (709.54 ± 259.0 pmol/l; P < 0.005) 60 min after injection in patients with early onset senile dementia, but no significant response was detected in the other two groups. Electroencephalographic recording showed that GHRH modifies brain bioelectrical activity, decreasing frequency (0.52 ± 0.15 Hz) and increasing amplitude (8.25 ± 4.5 μV) of the electroencephalogram basic rhythm. The evaluation of mental performance and behaviour with a battery of different tests for mental assessment revealed that GHRH induces transient clinical changes in psychomotor behaviour. According to these results, it seems likely that the somatostatin deficiency reported in senile dementia of the Alzheimer type may account for the enhanced GHRH-induced GH response observed in patients with early onset senile dementia. In consequence, the GHRH test might constitute a useful antemortem marker for senile dementia of the Alzheimer type if the present results can be replicated in early stages of the disease.