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Cognitive Impairment in Elderly People

Predisposing Factors and Implications for Experimental Drug Studies

  • Epidemiology
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Summary

The consequences for cognitive functioning of normal aging, depression and dementia are well known. However, the borderline between normal and pathological cognitive aging is less well understood. Recently, it has been found that it is important to differentiate between ‘successful’, ‘usual’ and pathological cognitive aging. This article reviews existing views on this borderline.

Recently, it has been found that health-related factors, or biological life events, may determine the rate of cognitive aging. Various different, but similar, diagnostic descriptions of age-related cognitive dysfunction exist simultaneously: benign senescent forgetfulness, malignant senescent forgetfulness, age-associated memory impairment, age-consistent memory impairment, late-life forgetfulness, mild cognitive changes (subthreshold) and cognitive impairment disorders are some examples of different diagnostic categories. There are also various diagnostic tools to obtain these experimental diagnoses; for example, the Global Deterioration Scale, the Clinical Dementia Rating Scale and the Cambridge Mental Disorders of the Elderly Examination. A diagnosis is considered important for the early detection of dementia.

Pharmacological treatments are still in the experimental stage. Improvement of cognitive function has particularly been studied in clinical trials with groups of patients with Alzheimer’s disease as well as patient groups with age-associated memory impairment. Future strategies may orient more towards treating symptoms of cognitive dysfunction, probably also on the basis of diagnosis of health-related factors, in age-related cognitive decline and depression.

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References

  1. Jolles J. Cognitive, emotional and behavioral dysfunctions in aging and dementia. In: Swaab DF, Fliers E, Mirmirian M, et al., editors. Progress in brain research. Amsterdam: Elsevier Science Publishers, 1986; 70: 15–39

    PubMed  CAS  Google Scholar 

  2. Birren JE, Warner Schaie K, editors. Handbook of the psychology of aging. 3rd ed. New York: Van Nostrand Reinhold Company, 1990

    Google Scholar 

  3. Botwinick J. Aging and behavior. 3rd ed. New York: Springer, 1984

    Google Scholar 

  4. Charness N, editor. Aging and human performance. Chichester: John Wiley & Sons, 1985

    Google Scholar 

  5. Salthouse TA. Speed of behavior and its implications for cognition. In: Birren JE, Schaie KW, editors. Handbook of the psychology of aging. New York: Van Nostrand Reinhold, 1985: 400–26

    Google Scholar 

  6. Masur DM, Sliwinski M, Lipton RB, et al. Neuropsychological prediction of dementia and the absence of dementia in healthy elderly persons. Neurology 1994; 44: 1427–32

    PubMed  CAS  Google Scholar 

  7. Ban TA. Psychopharmacology and successful cerebral aging. Prog Neuropsych Biol Psychiatry 1994; 19: 1–9

    Google Scholar 

  8. Michel B, Sambuc R, Scotto JC. French recommendations for clinical drug trials in cognitive disorders of the elderly. Int J Geriatr Psychiatry 1994; 9(10): 823–28

    Google Scholar 

  9. O’Brien JT, Levy R. Age associated memory impairment. BMJ 1992; 304: 5–6

    PubMed  Google Scholar 

  10. Verhey FRJ, Jolies J, Ponds RWHM, et al. Diagnosing dementia: comparison between a monodisciplinary and a multidisciplinary approach. J Neuropsychiatry Clin Neurosci 1993; 5(1): 78–85

    PubMed  CAS  Google Scholar 

  11. Huppert FA. Age-related changes in memory: learning and remembering new information. In: Boiler F, Grafman J, editors. Handbook of neuropsychology. Amsterdam: Elsevier Science Publishers, 1991: 123–47

    Google Scholar 

  12. LaRue A. Aging and neuropsychological assessment. New York: Plenum Press, 1992

    Google Scholar 

  13. Huppert FA, Tym E. Clinical and neuropsychological assessment of dementia. Br Med Bull 1986; 42: 11–8

    PubMed  CAS  Google Scholar 

  14. Morris JC, Heyman A, Mohs RC, et al. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Neurology 1989; 39: 1159–65

    PubMed  CAS  Google Scholar 

  15. Storandt M, Botwinick J, Danziger WL, et al. Psychometric differentiation of mild dementia of the Alzheimer type. Arch Neurol 1984; 41: 497–9

    PubMed  CAS  Google Scholar 

  16. Amaducci L, Angst J, Bech P, et al. Consensus conference on the methodology of clinical trials of ‘nootropics’; 1989 Jun 28–30: Munich. Report of the consensus committee. Pharmacopsychiatry, 1990; 23(4): 171–5

    PubMed  CAS  Google Scholar 

  17. Gray JA, Enz A, Spiegel R. Muscarinic agonists for senile dementia: past experience and future trends. Trends Pharmacol Sci 1989; 10: 85–8

    Google Scholar 

  18. Thal LJ. Clinical trials in Alzheimer’s disease. In: Terry RD, Katzman R, Bick KL, editors. Alzheimer’s disease. New York: Raven Press, 1994: 431–44

    Google Scholar 

  19. Whalley LJ. Drug treatments of dementia. Br J Psychiatry 1989; 155: 595–611

    PubMed  CAS  Google Scholar 

  20. Riedel WJ, Jolies J. Cognition enhancers in age-related cognitive decline. Drugs Aging. In press

  21. Birren JE, Warner Schaie K, editors. Handbook of the psychology of aging. 2nd ed. New York: Van Nostrand Reinhold Company, 1985

    Google Scholar 

  22. Reese HW, Rodeheaver D. Problem solving and decision making. In: Birren JE, Schaie KW, editors. Handbook of the psychology of aging. 2nd ed. New York: Van Nostrand Reinhold, 1985: 474–99

    Google Scholar 

  23. Plude DJ, Hoyer WJ. Attention and performance: identifying and localizing age deficits. In: Charness N, editor. Aging and human performance. Chichester: Wiley, 1985: 47–99

    Google Scholar 

  24. Woodruff DS. Arousal, sleep, and aging. In: Birren JE, Schaie KW, editors. Handbook of the psychology of aging, New York: Van Nostrand Reinhold, 1985: 261–95

    Google Scholar 

  25. Salthouse TA. Resource-reduction interpretations of cognitive aging. Dev Rev 1988; 8(3): 238–72

    Google Scholar 

  26. Houx PJ, Vreeling FW, Jolies J. Rigorous health screening reduces age effect on memory scanning task. Brain Cogn 1991; 15(2): 246–60

    PubMed  CAS  Google Scholar 

  27. Rabbitt PMA. Applied cognitive gerontology: some problems, methodologies and data. Appl Cogn Psychol 1990; 4: 225–46

    Google Scholar 

  28. Haug H. Are neurons of the human cerebral cortex really lost during aging? In: Traber J. Gispen WH, editors. Senile dementia of the Alzheimer type. Berlin: Springer Verlag, 1985: 150–63

    Google Scholar 

  29. Riegel KF, Riegel RM. A study of the drop-out rates in longitudinal research on aging and the prediction of death. J Pers Soc Psychol 1967; 4: 342–8

    Google Scholar 

  30. Riegel KF, Riegel RM. Development, drop, and death. Dev Psychol 1972; 6: 309–16

    Google Scholar 

  31. Houx PJ, Vreeling FW, Jolies J. Stroop interference: aging effects assessed with the Stroop Color-Word Test. Exp Aging Res 1993; 19: 209–24

    PubMed  CAS  Google Scholar 

  32. Jolies J, Houx PJ, Vreeling FW, et al. Cognitive aging, biological life events and primitive reflexes. Neurosci Res Commun 1994; 13 Suppl. 1: S47–S50

    Google Scholar 

  33. Rabbitt PMA, Goward LM. Effects of age and raw IQ test scores on mean correct and mean error reaction times in serial choice tasks: a reply to Smith & Brewer. Br J Psychol 1986; 77(1): 69–73

    Google Scholar 

  34. Geffen G, Moar KJ, O’Hanlon AP, et al. Performance measures of 16- to 86-year-old males and females on the auditory verbal learning test. Clin Neuropsychologist 1990; 4(1): 45–63

    Google Scholar 

  35. Verillo RT, Verillo V. Sensory and perceptual performance. In: Charness N, editor. Aging and human performance. Chichester: Wiley, 1985: 1–46

    Google Scholar 

  36. Stones MJ, Kozma A. Physical performance. In: Charness N, editor. Aging and human performance, Chichester: Wiley, 1985: 261–91

    Google Scholar 

  37. Houx PJ, Jolies J. Vulnerability factors for age-related cognitive decline. In: Isaacson RL, Jensen KF, editors. The vulnerable brain and environmental risks. New York: Plenum Press, 1994: 25–41

    Google Scholar 

  38. Houx PJ, Vreeling FW, Jolies J. Age-associated cognitive decline is related to biological life events. In: Iqbal K, McLachlan DRC, Winblad B, et al., editors. Alzheimer’s disease: basic mechanisms, diagnosis and therapeutic strategies. Chichester: John Wiley & Sons Ltd, 1991: 353–9

    Google Scholar 

  39. Houx PJ, Jolies J. Age-related decline of psychomotor speed: effects of age, brain health, sex and education. Percept Mot Skills 1993; 76: 195–211

    PubMed  CAS  Google Scholar 

  40. Vreeling FW, Jolies J, Verhey FRJ, et al. Primitive reflexes in Alzheimer’s disease and vascular dementia. J Geriatr Psychiatry Neurol 1995; 8(2): 111–7

    PubMed  CAS  Google Scholar 

  41. Fozard JL, Metter EJ, Brant LJ. Next steps in describing aging and disease in longitudinal studies. J Gerontol 1990; 43(4): 116–27

    Google Scholar 

  42. Colsher PL, Wallace RB. Epidemiologic considerations in studies of cognitive function in the elderly: methodology and non-dementing acquired dysfunction. Epidemiol Rev 1991; 13(1): 1–27

    PubMed  CAS  Google Scholar 

  43. Haxby JV, Grady CL, Duara R, et al. Relations among age, visual memory, and resting cerebral metabolism in 40 healthy men. Brain Cogn 1986; 5: 412–27

    PubMed  CAS  Google Scholar 

  44. Christensen KJ, Moye J, Armson RR, et al. Health screening and random recruitment for cognitive aging research. Psychol Aging 1992; 7: 204–8

    PubMed  CAS  Google Scholar 

  45. Elias MF, Robbins MA, Schultz NR, et al. Is blood pressure an important variable in research on aging and neuropsychological test performance? J Gerontol 1990; 45(4): 128–35

    Google Scholar 

  46. Hartman DE. Neuropsychological toxicology: identification and assessment of human neurotoxic syndromes. New York: Pergamom Press, 1988

    Google Scholar 

  47. Hijman R, Jolies J, Verhoeven WMA, et al. Desglycinamide-(Arg(8))-vasopressin in five trials with memory-disturbed patients. Hum Psychopharmacol 1992; 7(1): 7–23

    CAS  Google Scholar 

  48. Rowe JW, Kahn RL. Human aging: usual and successful. Science 1987; 237: 143–9

    PubMed  CAS  Google Scholar 

  49. Stones MJ, Kozma A, Hannah TE. The measurement of individual differences in aging: the distinction between usual and successful aging. In: Howe ML, Stones MJ, Brainerd CJ, editors. Cognitive and behavioral performance factors in atypical aging. New York: Springer Verlag, 1990: 181–218

    Google Scholar 

  50. Kay D, Bergmann K, Foster EM, et al. Mental illness and hospital usage in the elderly: a random sample followed up. Compr Psychiatry 1970; 11(l):26–35

    PubMed  CAS  Google Scholar 

  51. Henderson AS, Huppert FA. The problem of mild dementia. Psychol Med 1984; 14:5–11

    PubMed  CAS  Google Scholar 

  52. Henderson AS. The epidemiology of Alzheimer’s disease. Br Med Bull 1986; 42: 3–10

    PubMed  CAS  Google Scholar 

  53. Freemon F. Evaluation of patients with progressive intellectual deterioration. Arch Neurol 1976; 33: 658–9

    PubMed  CAS  Google Scholar 

  54. Hachinski V. Preventable dementia: a call for action against the vascular dementias. Lancet 1992; 340: 645–8

    PubMed  CAS  Google Scholar 

  55. Marsden C, Harrison M. Outcome of investigation of patients with presenile dementia. BMJ 1972; 2(808): 249–52

    PubMed  CAS  Google Scholar 

  56. Smith J, Kiloh L. The investigation of dementia: results in 200 consecutive admissions. Lancet 1981; ii: 824–7

    Google Scholar 

  57. Clarfield AM. The reversible dementias: do they reverse? Ann Intern Med 1988; 109: 476–86

    PubMed  CAS  Google Scholar 

  58. Larson EB, Reifler BV, Sumi SM, et al. Diagnostic evaluation of 200 elderly outpatients with suspected dementia. J Gerontol 1985; 40: 536–43

    PubMed  CAS  Google Scholar 

  59. Jolies J, Verhey FRJ. On the rationale behind treatment studies in cognitive aging and dementia. Paper presented at the Alzheimer’s Disease: back to the future. Amsterdam, 9 Oct 1992. Proceedings of the symposium on Alzheimer’s disease: recent advances in diagnosis and treatment. Amsterdam: Free University, 1993: 75–84

    Google Scholar 

  60. Commissaris CJAM, Verhey FRJ, Ponds RWHM, et al. Public education about normal forgetfulness and dementia: importance and effects. Patient Educ Couns 1994; 24: 109–15

    PubMed  CAS  Google Scholar 

  61. Commissaris CJAM, Jolies J, Verhey FRJ, et al. Forgetfulness or dementia? Who is worried and why. Eur J Public Health 1995. In press

  62. Commissaris CJAM, Ponds RWHM, Verhey FRJ, et al. Public education about normal forgetfulness and dementia: effectiveness of a systematically developed information brochure. Educ Gerontol 1995; 21: 763–77

    Google Scholar 

  63. Philpot MP, Levy R. Memory clinic for the early diagnosis of dementia. Int J Geriatr Psychiatry 1987; 2: 195–200

    Google Scholar 

  64. Aevarsson O, Skoog I. Prodromal symptoms of dementia. Neurobiol Aging 1992; 13 Suppl.: 5L

    Google Scholar 

  65. Persson G, Berg S, Nilsson L, et al. Subclinical dementia. Relation to cognition, personality and psychopathology: a nine-year prospective study. Int J Geriatr Psychiatry 1991; 6: 239–47

    Google Scholar 

  66. Rubin EH, Kinscherf DA. Psychopathology of very mild dementia of the Alzheimer type. Am J Psychiatry 1989; 146: 1017–21

    PubMed  CAS  Google Scholar 

  67. Bozolla FG, Gorelick PB, Freels S. Personality changes in Alzheimer’s disease. Arch Neurol 1992; 49: 297–300

    Google Scholar 

  68. Chatterjee A, Strauss ME, Smyth KA, et al. Personality changes in Alzheimer’s disease. Arch Neurol 1992; 49: 486–91

    PubMed  CAS  Google Scholar 

  69. Petry S, Cummings JL, Hill MA, et al. Personality alterations in dementia of the Alzheimer type. Arch Neurol 1988; 45: 1187–90

    PubMed  CAS  Google Scholar 

  70. Rubin EH, Morris JC, Berg L. The progression of personality changes in patients with mild senile dementia of the Alzheimer type. J Am Geriatr Soc 1987; 35: 721–5

    PubMed  CAS  Google Scholar 

  71. Bolla KI, Lindgren KN, Bonaccorsy C, et al. Memory complaints in older adults. Fact or fiction? Arch Neurol 1991; 48(1): 61–4

    PubMed  CAS  Google Scholar 

  72. Christensen, H. The validity of memory complaints by elderly people. Int J Geriatr Psychiatry 1991; 6: 307–12

    Google Scholar 

  73. McGlone J, Gupta S, Humphrey D, et al. Screening for early dementia using memory complaints from patients and relatives. Arch Neurol 1990; 47: 1189–93

    PubMed  CAS  Google Scholar 

  74. O’Brien JT, Beats B, Hill K, et al. Do subjective memory complaints precede dementia? A three year follow-up study of patients with supposed ‘benign senescent forgetfulness’. Int J Geriatr Psychiatry 1992; 7: 481–6

    Google Scholar 

  75. O’Connor DW, Pollitt PA, Roth M, et al. Memory complaints and impairment in normal, depressed and demented elderly persons identified in a community survey. Arch Gen Psychiatry 1990; 47: 224–7

    PubMed  Google Scholar 

  76. Plotkin DA, Mintz JM, Jarvik LF. Subjective memory complaints in geriatric depression. Am J Psychiatry 1985; 142: 1103–5

    PubMed  CAS  Google Scholar 

  77. Frederiks JAM. The neurology of aging and dementia. In: Bruyn D, editor. Handbook of clinical neurology. Amsterdam: Elsevier Science Publishers, 1985; 46: 199–219

    Google Scholar 

  78. Galasko D, Kwo-on-Yuen PF, Klauber MR, et al. Neurological findings in Alzheimer’s disease and normal aging. Arch Neurol 1990; 47: 625–7

    PubMed  CAS  Google Scholar 

  79. Storandt M, Hill RD. Very mild senile dementia of the Alzheimer type: 2. Psychometric test performance. Arch Neurol 1989; 46: 383–6

    PubMed  CAS  Google Scholar 

  80. Rubin EH, Morris JC, Grant EA, et al. Very mild senile dementia of the Alzheimer type: 1. Clinical assessment. Arch Neurol 1989; 46: 379–82

    PubMed  CAS  Google Scholar 

  81. Jobst KA, Smith AD, Szatmari M, et al. Detection in life of confirmed Alzheimer’s disease using a simple measurement of medial temporal lobe atrophy by computed tomography. Lancet 1992; 340: 1179–83

    PubMed  CAS  Google Scholar 

  82. Weinstein H. SPECT in Alzheimer’s disease. Amsterdam: University Press, 1992

    Google Scholar 

  83. Scheltens P, Leys D, Barkhof F. Hippocampal atrophy on magnetic resonance imaging in Alzheimer’s disease and normal aging. Neurology 1991; 41 Suppl. 1: 341–2

    Google Scholar 

  84. Soininen HS, Partanen K, Pitkanen A, et al. Volumetric MRI analysis of the amygdala and the hippocampus in subjects with age-associated memory impairment: correlation to visual and verbal memory. Neurology 1994; 44(9): 1660–8

    PubMed  CAS  Google Scholar 

  85. Robins E, Guze SB. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry 1970; 126: 983–7

    PubMed  CAS  Google Scholar 

  86. Verhey FRJ, Rozendaal N, Ponds RWHM, et al. Dementia, depression and awareness. Int J Geriatr Psychiatry 1993; 8: 851–6

    Google Scholar 

  87. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd rev. ed. Washington DC: American Psychiatric Association, 1987

    Google Scholar 

  88. Chui HC, Teng EL, Henderson VW, et al. Clinical subtypes of dementia of the Alzheimer type. Neurology 1985; 35: 1544–50

    PubMed  CAS  Google Scholar 

  89. McKhann G, Drachmann D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA workgroup under the auspices of the department of Health and Human Services task force on Alzheimer’s disease. Neurology 1984; 34: 939–44

    PubMed  CAS  Google Scholar 

  90. Román GC, Tatemichi TK, Erkinjuntii T, et al. Vascular dementia: diagnostic criterion for research studies. Report of the NINAIREN international workshop. Neurology 1993; 43: 250–60

    PubMed  Google Scholar 

  91. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington D.C.: American Psychiatric Association, 1994

    Google Scholar 

  92. Roth M, Tym E, Mountjoy CQ, et al. CAMDEX: a standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986; 149: 698–709

    PubMed  CAS  Google Scholar 

  93. Hachinski V, Illif L, Zilkha E, et al. Cerebral blood flow in dementia. Arch Neurol 1975; 32: 632–7

    PubMed  CAS  Google Scholar 

  94. Rosen WG, Mohs RC. Evolution of cognitive decline in dementia. In: Corkin S, editor. Alzheimer’s disease: a report of progress. New York: Raven Press, 1982: 183–8

    Google Scholar 

  95. Chui HC, Victoroff JI, Margolin D, et al. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology 1992; 42: 473–80

    PubMed  CAS  Google Scholar 

  96. Verhey FRJ, Lodder J, Rozendaal N, et al. Criteria for the clinical diagnosis of vascular dementia: a comparison between seven current sets. Neuroepidemiology. In press

  97. Kral VA. Neuro-psychiatric observations in an old people’s home. J Gerontol 1958; 13: 169–76

    PubMed  CAS  Google Scholar 

  98. Reisberg B, Ferris SH, De Leon MJ, et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139(9): 1136–9

    PubMed  CAS  Google Scholar 

  99. Hughes CP, Berg L, Danziger WL, et al. A new rating scale for the staging of dementia. Br J Psychiatry 1982; 140: 566–72

    PubMed  CAS  Google Scholar 

  100. Crook T, Bartus RT, Ferris SH, et al. Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change. Report of a National Institute of Mental Health work group. Dev Neuropsychol 1986; 2(4): 261–76

    Google Scholar 

  101. Blackford RC, LaRue A. Criteria for diagnosing age-associated memory impairment: proposed improvements from the field. Dev Neuropsychol 1989; 5(4): 295–306

    Google Scholar 

  102. Caine ED. Should aging-associated cognitive decline be included in DSM-IV? J Neuropsychiatry Clin Neurosci 1993; 5(1): 1–5

    PubMed  CAS  Google Scholar 

  103. Spitzer R, First MB, Williams JBW, et al. Now is the time to retire the term ‘organic mental disorders’. Am J Psychiatry 1992; 149: 240–4

    PubMed  CAS  Google Scholar 

  104. Dawe B, Procter A, Philpot M. Concepts of memory impairment in the elderly and their relationship to dementia — a review. Int J Geriatr Psychiatry 1992; 7: 473–9

    Google Scholar 

  105. Kral VA. Senescent forgetfulness: benign and malignant. Can Med Assoc J 1962; 86: 257–60

    PubMed  CAS  Google Scholar 

  106. Ferris SH, Flicker C, Reisberg B, et al. Age-associated memory impairment, benign forgetfulness and dementia. In: Bergener M, Reisberg B, editors. Diagnosis and treatment of senile dementia. Berlin: Springer Verlag, 1989: 72–82

    Google Scholar 

  107. McEntee WJ, Crook TH. Age-associated memory impairment: a role for catecholamines. Neurology 1990; 40: 526–30

    PubMed  CAS  Google Scholar 

  108. Derouesné C, Kalafat M, Guez D, et al. The age-associated memory impairment construct revisited. Int J Geriatr Psychiatry 1994; 9: 577–87

    Google Scholar 

  109. Popkin MK, Tucker G, Caine E, et al. The fate of organic mental disorders in DSM-VI: a progress report. Psychosomatic s 1989; 30: 438–41

    CAS  Google Scholar 

  110. Spitzer R, Williams JBW, First M. A proposal for DSM-IV: solving the ‘organic-nonorganic’ problem. J Neuropsychiatry Clin Neurosci 1989; 1(2): 126–27

    PubMed  CAS  Google Scholar 

  111. Forette F, Henry J, Orgogozo J. Reliability of clinical criterion for the diagnosis of dementia. Arch Neurol 1989; 46: 646–8

    PubMed  CAS  Google Scholar 

  112. Huff FJ, Becker JT, Belle SH, et al. Cognitive deficits and clinical diagnosis of Alzheimer’s disease. Neurology 1987; 37: 1119–24

    PubMed  CAS  Google Scholar 

  113. Nielsen H, Lolk A, Pedersen I, et al. The accuracy of early diagnosis and predictors of death in Alzheimer’s disease and vascular dementia — a follow-up study. Acta Psychiatr Scand 1991; 84: 277–82

    PubMed  CAS  Google Scholar 

  114. Burke WJ, Miller JP, Rubin EH, et al. The reliability of the Washington University Clinical Dementia Rating. Arch Neurol 1988; 45: 31–2

    PubMed  CAS  Google Scholar 

  115. Berg L, Miller JP, Baty J, et al. Mild senile dementia of the Alzheimer type. 3. Longitudinal and cross-sectional assessment. Ann Neurol 1990; 28: 648–52

    PubMed  CAS  Google Scholar 

  116. Roth M, Huppert FA, Tym E, et al. CAMDEX: the Cambridge examination for mental disorders of the elderly. Cambridge: University Press, 1988

    Google Scholar 

  117. O’Connor D, Pollit PA, Hyde JB, et al. Clinical issues relating to the diagnosis of mild dementia in a British community survey. Arch Neurol 1991; 48: 530–4

    PubMed  Google Scholar 

  118. O’Connor DW, Pollit PA, Hyde JB, et al. A follow-up study of dementia diagnosed in the community using the Cambridge Mental Disorders of the elderly examination. Acta Psychiatr Scand 1990; 81: 78–82

    PubMed  Google Scholar 

  119. Fratiglioni FY, Grut M, Viitanen GM, et al. Clinical staging of dementia in a population survey: comparison of DSM-III-R and the Washington University Clinical Dementia Rating scale. Acta Psychiatr Scand 1992; 86:49–54

    PubMed  Google Scholar 

  120. Mowry BJ, Burvill PW. A study of mild dementia in the community using a wide range of diagnostic criterion. Br J Psychiatry 1988; 153: 328–34

    PubMed  CAS  Google Scholar 

  121. Hultsch DF, Hertzog C, Dixon RA, et al. Memory self-knowledge and self-efficacy in the aged. In: Lowe ML, Brainerd CJ, editors. Cognitive development in adulthood: progress in cognitive developmental research. New York: Springer Verlag, 1988: 65–92

    Google Scholar 

  122. Shimamura AP, Squire LR. Memory and metamemory: a study of the feeling-of-knowing phenomenon in amnestic patients. J Exp Psychol 1986; 12: 452–60

    CAS  Google Scholar 

  123. Sunderland A, Watts K, Baddeley AD, et al. Subjective memory assessment and test performance in elderly adults. J Gerontol 1986; 41: 376–84

    PubMed  CAS  Google Scholar 

  124. Reding M, Haycox J, Blass J. Depression in patients referred to a dementia clinic: a three year prospective study. Arch Neurol 1985; 42: 894–6

    PubMed  CAS  Google Scholar 

  125. Welsh K, Butters N, Hughes J, et al. Detection of abnormal memory decline in mild cases of Alzheimer’s disease using CERAD neuropsychological measures. Arch Neurol 1991; 48: 278–81

    PubMed  CAS  Google Scholar 

  126. Berrios GE. Non-cognitive symptoms and the diagnosis of dementia: history and clinical aspects. Br J Psychiatry 1989; 154 Suppl. 4: 11–6

    Google Scholar 

  127. Folstein MF, Bijlsma PW. Noncognitive symptoms of Alzheimer’s disease. In: Terry R, Katzman R, Bick K, editors. Alzheimer disease. New York: Raven Press, 1994: 27–40

    Google Scholar 

  128. Rabins PV. Noncognitive symptoms in Alzheimer’s disease: definitions, treatments and possible etiologies. In: Terry R, Katzman R, Bick K, editors. Alzheimer disease. New York: Raven Press, 1994: 419–30

    Google Scholar 

  129. Brayne C, Calloway P. Normal ageing, impaired cognitive function, and senile dementia of the Alzheimer’s type: a continuum? Lancet 1988; i(8597): 1265–7

    Google Scholar 

  130. Kiloh LG. Pseudodementia. Acta Psychiatr Scand 1961; 37: 336–51

    PubMed  CAS  Google Scholar 

  131. Kral VA, Emery O. Long term follow-up of depressive pseudodementia. Can J Psychiatry 1989; 34: 445–7

    PubMed  CAS  Google Scholar 

  132. Roberts JKA. Differential diagnosis in neuropsychiatry. Chichester: Wiley & Sons, 1984

    Google Scholar 

  133. LaRue A, Watson J, Plotkin DA. First symptoms of dementia: a study of relatives’ reports. Int J Geriatr Psychiatry 1993; 8: 239–45

    Google Scholar 

  134. Katzman R, Aronson M, Fuld P, et al. Development of dementing illnesses in an 80-year-old volunteer cohort. Ann Neurol 1989; 25: 317–24

    PubMed  CAS  Google Scholar 

  135. Crystal H, Dickson D, Fuld P, et al. Clinico-pathological studies in dementia: nondemented subjects with pathologically confirmed Alzheimer’s disease. Neurology 1988; 38: 1682–7

    PubMed  CAS  Google Scholar 

  136. Amaducci L, Fratiglioni L. Epidemiology of AD: impact on the treatment. In: Giacobini E, Becker RE, editors. Alzheimer’s disease: therapeutic strategies. Basel: Birkhäuser Verlag, 1994: 8–16

    Google Scholar 

  137. Katzman R, Kawas CH. The epidemiology of dementia and Alzhmeimer’s disease. In: Terry R, Katzman R, Bick K, editors. Alzheimer disease. New York: Raven Press, 1994: 105–22

    Google Scholar 

  138. Fenn H, Luby V, Yesavage JA. Subtypes in Alzheimer’s disease and the impact of excess disability: recent findings. Int J Geriatr Psychiatry 1993; 8: 67–73

    Google Scholar 

  139. Ritchie K, Touchon J. Heterogeneity in senile dementia of the Alzheimer type: individual differences, progressive deterioration or clinical subtypes? J Clin Epidemiol 1992; 45: 1391–8

    PubMed  CAS  Google Scholar 

  140. Corder E, Sauders A, Strittmaier W, et al. Gene dose of apolipoprotein E Type 4 allele and the risk of Alzheimer’s disease in late onset families. Science 1993; 261: 921–3

    PubMed  CAS  Google Scholar 

  141. Scinto LFM, Daffner KM, Dressier D, et al. A potential noninvasive neurobiological test for Alzheimer’s disease. Science 1994; 266: 1051–4

    PubMed  CAS  Google Scholar 

  142. Food and Drug Administration. Tacrine as a treatment for Alzheimer’s Dementia. An interim report from the FDA. N Engl J Med 1991; 324: 349–52

    Google Scholar 

  143. Giacobini E, Becker R. Development of drugs for Alzheimer therapy: a decade of progress. In: Giacobini E, Becker RE, editors. Alzheimer’s disease: therapeutic strategies. Basel: Birkhäuser Verlag, 1994: 1–7

    Google Scholar 

  144. Wolkowitz OM, Tinklenberg JR, Weingartner HA. Psychopharmacological perspective of cognitive functions. Neuropsychobiology 1985; 14: 88–96

    PubMed  CAS  Google Scholar 

  145. Corkin S, Growdon JH, Sullivan EV, et al. Assessing treatment effects: a neuropsychological battery. In: Poon LW, editor. Handbook for clinical memory assessment of older adults. Washington: American Psychological Association, 1986: 156–7

    Google Scholar 

  146. Tyrell P, Hardy J, Rosor M. Tetrahydroaminoacridine and Alzheimer’s disease. Lancet 1987; i(8530): 444–5

    Google Scholar 

  147. Jansen KLR. Is treating memory impairment in Alzheimer’s disease an objective? Trends Neurosci 1988; 11: 210

    PubMed  CAS  Google Scholar 

  148. Weinstein HC, Teunisse S, Van Gool WA. Tetrahydroamineacridine and lecithine in treatment of Alzheimer’s disease: effect on cognition, functioning in daily life, behavioral disturbances and burden experienced by the carers. J Neurol 1991; 238: 34–8

    PubMed  CAS  Google Scholar 

  149. Crook T. Pharmacotherapy of cognitive deficits in Alzheimer’s disease and age associated memory impairment. Psychopharmacol Bull 1988; 24: 31–8

    PubMed  CAS  Google Scholar 

  150. Brand N, Jolles J. Information processing in depression and anxiety. Psychol Med 1987; 17(1): 145–53

    PubMed  CAS  Google Scholar 

  151. Nilsson LG, Backman L, Karlsson T. Priming and cued recall in elderly, alcohol intoxicated and sleep deprived subjects: a case of functionally similar memory deficits. Psychol Med 1989; 19(2): 423–33

    PubMed  CAS  Google Scholar 

  152. Riedel WJ, Van Praag HM. Avoiding and managing anticholinergic effects of antidepressants. CNS Drugs 1995; 3(4): 245–59

    CAS  Google Scholar 

  153. Lister RG. The effects of benzodiazepines and 5-HT1A agonists on learning and memory. In: Rodgers RJ, Cooper SJ, editors. 5-HT1A agonists, 5-HT3 antagonists and benzodiazepines. Chichester: Wiley, 1991: 267–80

    Google Scholar 

  154. Gaillard AWK, Gruisen A, De Jong R. The Influence of antihistamines on human performance. Eur J Clin Pharmacol 1988; 35(3): 249–54

    PubMed  CAS  Google Scholar 

  155. Ramaekers JG, O’Hanlon JF. Acrivastine, terfenadine and diphenhydramine effects on driving performance as a function of dose and time after dosing. Eur J Clin Pharmacol 1994; 47(3): 261–6

    PubMed  CAS  Google Scholar 

  156. Jones RW, Wesnes KA, Kirby J. Effects of NMDA modulation in scopolamine dementia. Ann NY Acad Sci 1991; 640:241–4

    PubMed  CAS  Google Scholar 

  157. Molchan SE, Mellow AM, Lawlor BA, et al. TRH attenuates scopolamine-induced memory impairment in humans. Psychopharmacol 1990; 100(1): 84–9

    CAS  Google Scholar 

  158. Preston GC, Ward C, Lines CR, et al. Scopolamine and benzodiazepine models of dementia: cross-reversals by Ro 15-1788 and physostigmine. Psychopharmacology 1989; 98(4): 487–94

    PubMed  CAS  Google Scholar 

  159. Wesnes K, Jones RW, Kirby J. The effects of D-cycloserine, a glycine agonist, in a human model of the cognitive deficits associated with ageing and dementia. Br J Clin Pharmacol 1991; 31: 577–8

    Google Scholar 

  160. Preda L, Alberoni M, Bressi S, et al. Effects of acute doses of oxiracetam in the scopolamine model of human amnesia. Psychopharmacology 1993; 110(4): 421–6

    PubMed  CAS  Google Scholar 

  161. Wesnes KA, Anand R, Simpson PM, et al. The use of a scopolamine model to study the potential nootropic effects of aniracetam and piracetam in healthy volunteers. J Psychopharmacol 1990; 4(4): 219–32

    PubMed  CAS  Google Scholar 

  162. Riedel WJ, Hogervorst E, Leboux RLAM, et al. Caffeine attenuates scopolamine-induced memory impairment in humans. Psychopharmacology. In press

  163. Rusted J, Eaton-Williams P. Distinguishing between attentional and amnestic effects in information processing: the separate and combined effects of scopolamine and nicotine on verbal free recall. Psychopharmacology 1991; 104(3): 363–6

    PubMed  CAS  Google Scholar 

  164. Wesnes K, Revell A. The separate and combined effects of scopolamine and nicotine on human information processing. Psychopharmacology 1984; 84(1): 5–11

    PubMed  CAS  Google Scholar 

  165. Rush CR, Higgins ST, Hughes JR, et al. Acute behavioral effects of triazolam and caffeine, alone and in combination, in humans. Exp Clin Psychopharmacol 1994; 2(3): 211–22

    CAS  Google Scholar 

  166. Hasenfratz M, Bunge A, Dal Pra G, et al. Antagonistic effects of caffeine and alcohol on mental performance parameters. Pharmacol Biochem Behav 1993; 46(2): 463–5

    PubMed  CAS  Google Scholar 

  167. Jarvis M. Does caffeine intake enhance absolute levels of cognitive performance? Psychopharmacology 1993; 110: 45–52

    PubMed  CAS  Google Scholar 

  168. Wesnes K, Parrott A. Smoking, nicotine and human performance. Handbook of human performance. London: Academic Press, 1992: 127–67

    Google Scholar 

  169. Van Duijn M, Hofman A. Relation between nicotine intake and Alzheimer’s disease. BMJ 1991; 302: 1491–4

    PubMed  Google Scholar 

  170. Meador KJ, Nichols ME, Franke P, et al. Evidence for a central cholinergic effect of high-dose thiamine. Ann Neurol 1993; 34(5): 724–6

    PubMed  CAS  Google Scholar 

  171. Deijen JB, Van der Beek EJ, Orlebeke JF, et al. Vitamin B-6 supplementation in elderly men: effects on mood, memory, performance and mental effort. Psychopharmacology 1992; 109(4): 489–96

    PubMed  CAS  Google Scholar 

  172. Bohnen N, Jolies J, Degenaar CP. Lower blood levels of vitamin B12 are related to decreased performance of healthy subjects in the Stroop Color Word Test. Neurosci Res Commun 1992; 11(1): 53–6

    CAS  Google Scholar 

  173. Bohnen N, Jolies J, Degenaar CP. Levels of trace elements in blood in healthy ageing subjects. Z Gerontol 1994; 27: 324–7

    PubMed  CAS  Google Scholar 

  174. Jolies J, Houx PJ, Vreeling FW, et al. Biological risk factors for accelerated cognitive aging and dementia: findings from a multiple cohort study. Neurobiol Aging 1990; 11(3): 293

    Google Scholar 

  175. Riedel WJ, Jolies J. Decreased blood level of zinc: does it explain age-associated-memory-impairment? Neuropsychopharmacology 1993; 9 (2 Suppl.): 57

    Google Scholar 

  176. Levy R. Aging-associated cognitive decline: working party of the International Psychogeriatric Association in collaboration with WHO. Int Psychogeriatr 1994; 6: 63–8

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Maastricht Brain and Behaviour Institute, and Department of Psychiatry and Neuropsychology, Section of Neuropsychology, Limburg University, P.O. Box 616, 6200, MD Maastricht, The Netherlands

    J. Jolles, F. R. J. Verhey, W. J. Riedel & P. J. Houx

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  1. J. Jolles
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  2. F. R. J. Verhey
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  3. W. J. Riedel
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  4. P. J. Houx
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Jolles, J., Verhey, F.R.J., Riedel, W.J. et al. Cognitive Impairment in Elderly People. Drugs & Aging 7, 459–479 (1995). https://doi.org/10.2165/00002512-199507060-00006

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