Psychiatric and Psychological Observations in a Geriatric Clinic

Abstract

1. A report is given on 47 patients seen during the first 10 months of operation of a multidisciplinary geriatric clinic. 2. Psychological tests were performed on 42 of these patients. They revealed a low average I.Q. and E.Q. of the group as a whole probably due, in part, to the life long low socio-economic status of the patients, and more so to the fact that about two-thirds of those tested showed “organic signs” on psychological tests. 3. In spite of this, only 19% of the group showed clinical signs of organic brain disease. This is taken as an indication of a remarkable capacity to compensate for organic deficits even at advanced age. It is suggested that “personal factors” may be responsible for this capacity. 4. Therapeutic measures to be taken with the different diagnostic groups are suggested.

V. A. Kral and the origins of benign senescent forgetfulness and mild cognitive impairment

“…For Kral and Wigdor (1961;1963) "well preserved" referred to the "general behavior of the residents in the Home and to their relationship with the outside world. After Rorschach in 1921, they were the first to study it in senile dementia, with the Wechsler Adult Intelligence Scale, the Bender Gestalt and the Rorschach test among referrals to the Geriatric Clinic of the Jewish General Hospital (Kral and Wigdor, 1957), and with the WMS in a study of the amnestic syndrome in various organic conditions (Kral and Durost, 1953). They were able to visit with their relatives, or to enjoy their visits in the Home; some did their own shopping, visited a nearby library, or went to religious ceremonies or shows."…”

“…I begin with a short professional biography of Kral (based on the biography and publications provided by Merskey (1989) and Lauter (1991)), followed by a description of the locus operandi of Kral's research on BSF, before describing the surveys and classifications from which BSF and MCI supposedly derived. At the same time, he was consultant in the Geriatric Clinic of the Jewish General Hospital one of the first to use a multidisciplinary team approach (Kral and Wigdor, 1957), and from 1955 he was also a consultant in the Montreal Hebrew Old People's and Sheltering Home (Heinik, 2006). Although Kral's interest in memory disturbances can be traced back to the early 1930s, his major initial research on amnestic syndromes and dementia was undertaken in the late 1940s and early 1950s while at Verdun (Kral, 1951;1956;Dörken and Kral, 1951;Kral and Durst, 1953 (Shorter, 2005).…”

“…Kral then moved to the Allan Memorial Institute of Psychiatry in Montreal where, from 1953 under D. Ewen Cameron, he served as Director of the Gerontologic Unit, the first of its kind inaugurated in North America in 1944 (Shorter, 2005). At the same time, he was consultant in the Geriatric Clinic of the Jewish General Hospital one of the first to use a multidisciplinary team approach (Kral and Wigdor, 1957), and from 1955 he was also a consultant in the Montreal Hebrew Old People's and Sheltering Home (Heinik, 2006). Between 1952 and 1972 he was a lecturer and ultimately associate professor at McGill University.…”

“…imipramine, thioridazine), and the androgen effect on senescent memory (Merskey, 1989). During this period, while a consultant to the Montreal Hebrew Old People's and Sheltering Home (hereafter the Home), Kral composed his “core” works (Kral, 1958; 1962; Kral and Wigdor 1961; 1963; Wigdor and Kral, 1961) on memory disorders in the elderly. London, Ontario . After retiring he was invited in 1972 to London, Ontario, where he continued his clinical and research activities until his death in 1988.…”

Some Trends in Geriatric Psychiatry

“…These patients have to adjust to a new and mostly unfavourable situation at a time of life when the capacity for adapta tion weakens (29). The most important factors involved are the loss of prestige among family and friends, the loss of a life-long occupation, be it a job or house keeping, decreased earning capacity and frequently a drastic loss of income.…”