To determine the prevalence of unrecognized brain dysfunction accompanying chronic severe cardiac disease, we examined 20 clinically stable consecutive admissions to a cardiac rehabilitation service who were free of known stroke or dementia. Age range was 47 to 85 years (mean +/- SEM, 72.5 +/- 2.1 years), the male: female ratio was 10:10. Multiple cognitive deficits including significant memory impairment and disorientation were present in eight patients (40%), and seven of these eight patients were unable to administer their own medications reliably. An additional six patients (30%) showed milder impairments. One patient was found to be normal after neurological examination, four showed evidence of a single brain lesion, and 15 of 20 (75%) had multiple neurological abnormalities suggesting multifocal brain disease. The mechanism of cognitive deficits in cardiac patients is unclear, and it may be related to multiple infarcts, or acute or chronic hypoxic damage secondary to arrhythmias, cardiac failure, or small vessel disease of the brain. The term "circulatory dementia" is proposed to describe patients with vascular disease and non-Alzheimer type dementia. Patients with cardiac disease should undergo cognitive screening, as early identification of patients at risk of progressive intellectual loss may allow early use of preventive therapy.
It is generally assumed that properties of the phrasal head determine the properties of a syntactic phrase as a whole. This chapter shows that some possessive constructions present a challenge to these assumptions, since in such constructions internal possessors, standardly analysed as dependents of possessed head nouns, exhibit a number of head-like properties. These properties determine the behaviour of the whole phrase in the larger syntactic domain. Such possessors are referred to as ‘prominent internal possessors’ (PIPs). The chapter provides a typological overview of PIPs based on a survey of approximately sixty languages from different parts of the world. It discusses the role of PIPs in two syntactic processes, namely, indexing on the verb via grammatical agreement or pronominal incorporation and switch-reference, as well as accompanying functional effects. It also addresses the question of how the phenomenon of PIPs can be accounted for in theoretical terms.
Mismatches in the morphosyntactic features of controllers and targets in the Eleme (Ogonoid, Niger-Congo) participant reference system allow for a subject agreement paradigm in which the person of the grammatical subject is indicated by a verbal prefix, while plural number is marked by a suffix on different targets — either lexical verbs or auxiliaries — based on the person value of the controller. I examine the distribution of Eleme ‘Default Subject’ agreement affixes and the intra-paradigmatic asymmetry found between second-person plural and third-person plural subjects in Auxiliary Verb Constructions (AVC) and Serial Verb Constructions (SVC). I argue that the criteria by which the various agreement affixes select an appropriate morphological host can be modelled in terms of agreement prerequisites even when distributional variation is paradigm internal.
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