A New Clinical Scale for the Staging of Dementia

Hughes, Charles P.; Berg, Leonard van den; Danziger, Warren L.; Coben, Lawrence A.; Martin, Ronald L.

doi:10.1192/bjp.140.6.566

Cited by 6,270 publications

(4,436 citation statements)

References 25 publications

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“…The inclusionary and exclusionary criteria for DAT are consistent with the NINCDS-ADRDA criteria (McKhann et al, 1984). The severity of dementia was staged according to the Washington University Clinical Dementia Rating (CDR) scale (Berg, 1988;Hughes, Berg, Danziger, Coben, & Martin, 1982;Morris, 1993). According to this scale, CDR 0, 0.5, 1, 2, and 3 represent no dementia, very mild dementia, mild dementia, moderate dementia, and severe dementia, respectively.…”

Section: Methodsmentioning

confidence: 99%

Does expanded retrieval produce benefits over equal-interval spacing? Explorations of spacing effects in healthy aging and early stage Alzheimer's disease.

Balota

Duchek

Sergent-Marshall

et al. 2006

Psychology and Aging

112

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Three experiments explored different schedules of retrieval practice in young adults, older adults, and individuals with dementia of the Alzheimer type. In each experiment, an initial acquisition phase was presented in which participants studied or attempted to retrieve response words to cues, followed by a later cued-recall test. Experiment 1 produced a benefit of expanded retrieval over equal-interval retrieval during acquisition, but this benefit was lost in final cued recall. In Experiments 2 and 3, participants received corrective feedback during acquisition and modified spacing schedules. There was again no evidence of a difference between expanded and equal-interval conditions in final cued recall. Discussion focuses on the potential benefits and costs of expanded retrieval on a theoretical and applied level.Keywords: aging, Alzheimer's disease, memory, retrievalThe advantage of spaced learning episodes over massed learning episodes is one of the most fundamental characteristics in learning (see, e.g., Crowder, 1976, Chapter 9). In the present study, we examine an extension of the spacing effect that has considerable potential for maximizing the benefits of spacing. Specifically, a particular type of spacing that expands the interval between learning episodes appears to afford an additional advantage over a spacing schedule that equally spaces the study episodes. For example, in learning the name of a new person just introduced, one might use an expanded practice schedule by retrieving the name at an interval of 15 s, 45 s, and 60 s, compared with an equally spaced practice of retrieving the name pair every 40 s. This particular type of spacing, referred to as expanded retrieval practice, has been extended to applied situations, including educational settings (e.g., Rea & Modigliani, 1985), and to individuals with memory impairments, such as individuals with early stage dementia of the Alzheimer's type (DAT; e.g., Camp, Foss, Stevens, & O'Hanlon, 1996).The goal of the present series of experiments is to explore the benefits of expanded retrieval in young adults, healthy older adults, and individuals with early stage DAT. First, we briefly review the empirical evidence for this phenomenon, the potential theoretical accounts, and why one might be especially interested in this procedure in these particular groups of individuals. Evidence for Benefits of Expanded Over Equal-IntervalSpaced Retrieval Landauer and Bjork (1978) were the first to fully explore the benefits of expanded retrieval over equal-interval spacing in two controlled experiments. In their first experiment, participants were initially presented a deck of cards that included fictitious first and second names of individuals. We refer to this as the acquisition phase. For present purposes, we focus on the trials in which participants were first presented both the first and second names intact, followed at varying schedules of receiving cards with only the first name of the study pair as a retrieval cue for the second name. For example, in the ex...

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Section: Methodsmentioning

confidence: 99%

Does expanded retrieval produce benefits over equal-interval spacing? Explorations of spacing effects in healthy aging and early stage Alzheimer's disease.

Balota

Duchek

Sergent-Marshall

et al. 2006

Psychology and Aging

112

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“…Patients were rated with a series of standardized diagnostic and severity instruments, including the MMSE (Folstein et al, 1975), the Clinical Dementia Rating Scale (CDRS; Hughes et al, 1982), the Geriatric Depression Scale (GDS, Yesavage et al, 1982), the Hachinski Ischemic Scale (Rosen et al, 1980), and the Instrumental Activities of Daily Living (IADL, Lawton and Brodie, 1969). In addition, patients underwent diagnostic neuroimaging procedures (head computed tomography or magnetic resonance imaging (MRI)) and laboratory testing to rule out other causes of dementia.…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Individual analysis of EEG frequency and band power in mild Alzheimer's disease

Moretti

Babiloni

Binetti

et al. 2004

Clinical Neurophysiology

327

251

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Objective: This EEG study investigates the role of the cholinergic system, cortico-cortical connections, and sub-cortical white matter on the relationship between individual EEG frequencies and their relative power bands.Methods: EEGs were recorded at rest in 30 normal elderly subjects (Nold), 60 mild Alzheimer disease (AD) and 20 vascular dementia (VaD) patients, comparable for Mini Mental State Evaluation scores . Individual EEG frequencies were indexed by the theta/alpha transition frequency (TF) and by the individual alpha frequency (IAF) with power peak in the extended alpha range (5 -14 Hz). Relative power was separately computed for delta, theta, alpha1, alpha2, and alpha3 bands, on the basis of the TF and IAF.Results: Using normal subjects as a reference, VaD patients showed 'slowing' of alpha frequency (TF-IAF) and lower alpha2 power; Mild AD patients showed lower alpha2 and alpha3 power; delta power was higher in both AD and VaD patients; Theta power was higher only in VaD patients.Conclusions: Individual analysis of the alpha frequency and power can discriminate mild AD from VaD and normal elderly subjects.Significance: This analysis may probe pathophysiological mechanisms causing AD and VaD.

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“…17,18 Their caregivers were also questioned for the presence of sociopathic acts on the basis of a modification of a criterion for antisocial personality disorder, 19 that is, “failure to conform to social norms with respect to lawful behaviors, as indicated by performing an act that brought him/her to legal attention.” For the patients identified as having sociopathic behavior, medical records were reviewed for evidence that they were not in a confusional state or delirium and knew what they were doing at the time of the actual events or sociopathic acts.…”

Section: Methodsmentioning

confidence: 99%

The Spectrum of Sociopathy in Dementia

Mendez¹,

Shapira²,

Saul³

2011

Journal of Neuropsychiatry

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Although well-known from head trauma and acute strokes, sociopathic behavior from dementia is less known and understood. This study reviewed 33 dementia patients who had been in trouble with the law. They were divided into two groups: 22 who committed impulsive sociopathic acts and 11 who committed non-impulsive acts. The impulsive patients demonstrated nonviolent acts, such as dis-inhibited sexual behavior or pathological stealing, and had disproportionate frontal-caudate atrophy on neuroimaging. The majority of non-impulsive patients demonstrated agitation-paranoia, sometimes with reactive aggression, delusional beliefs, or aphasic paranoia, and had advanced memory and other cognitive impairment. The impulsive patients tended to have frontally predominant illnesses such as frontotemporal dementia or Huntington’s disease, whereas the non-impulsive group tended to have Alzheimer’s disease or prominent aphasia. Sociopathy has different causes in dementia. Two common mechanisms are disinhibition, with frontally predominant disease, and agitation-paranoia, with greater cognitive impairment. These forms of sociopathy differ significantly from the antisocial/ psychopathic personality.

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A New Clinical Scale for the Staging of Dementia

Cited by 6,270 publications

References 25 publications

Does expanded retrieval produce benefits over equal-interval spacing? Explorations of spacing effects in healthy aging and early stage Alzheimer's disease.

Does expanded retrieval produce benefits over equal-interval spacing? Explorations of spacing effects in healthy aging and early stage Alzheimer's disease.

Individual analysis of EEG frequency and band power in mild Alzheimer's disease

The Spectrum of Sociopathy in Dementia

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