Advertisement

The Reversible Dementias: Do They Reverse?

  • A. Mark Clarfield
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 282)

Abstract

Over the last two decades, the possibility of finding (and curing) the reversible dementias has gained wide currency. As a result, multiple bodies (1–4) and individuals (5–9) have recommended more or less extensive workups for the demented patient, hoping thereby to ensure that no potentially reversible cases are missed.

Keywords

Subdural Hematoma Senile Dementia Demented Patient Normal Pressure Hydrocephalus Consecutive Admission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

Introduction References

  1. 1.
    National Institute on Aging Task Force: Senility reconsidered: treatment possibilities for mental impairment in the elderly (1980). JAMA, 244: 259–263.Google Scholar
  2. 2.
    Council on Scientific Affairs, American Medical Association: Dementia (1986). JAMA, 256: 2234–2238.Google Scholar
  3. 3.
    NIH Consensus Conference: Differential diagnosis of dementing diseases (1987). JAMA, 258: 3411–3416.Google Scholar
  4. 4.
    Royal College of Physicians Committee on Geriatrics. Organic mental impairment in the elderly: implications for research, education, and the provision of services (1981). J. R. College of Physicians, London, 15: 141–67.Google Scholar
  5. 5.
    Larson, E. G., Reifler, B. V., Sumi, S. M. (1986). Diagnostic tests in the evaluation of dementia: a prospective study of 200 elderly outpatients. Arch. Intern. Med., 126: 1917–1922.CrossRefGoogle Scholar
  6. 6.
    Clarfield, A. M. (1988). The reversible dementias: do they reverse? Ann. Intern. Med., 109: 476–486.PubMedGoogle Scholar
  7. 7.
    Clarfield, A. M. (1989). Diagnostic assessment of dementia. [Letter]. Ann. Intern. Med., 110: 670.Google Scholar
  8. 8.
    Wilson, D. B., Guyatt, G. H. Streiner, D. L. (1987). The diagnosis of dementia. Can. Med. Assoc. J., 137: 625–629.Google Scholar
  9. 9.
    Barry, P. P., Moskowitz, M. A. (1988). The diagnosis of reversible dementia in the elderly: a critical review. Arch. Int. Med., 148: 1914–1918.CrossRefGoogle Scholar
  10. 10.
    Sackett, D. L. (1979). Biases in analytic research. J. Chronic Dis., 32: 51–63.PubMedCrossRefGoogle Scholar
  11. 11.
    Clarfield, A. M., Friedman, R. (1985). A survey of the age structure of “age-relevant” articles in four medical journals. J. Amer. Ger. Soc., 33: 773–778.Google Scholar
  12. 12.
    Evans, D. A., Funkenstein, H. H., Albert, M. S. (1989). Prevalence of Alzheimer’s disease in a community population of older persons. JAMA, 262: 2551–56.PubMedCrossRefGoogle Scholar
  13. 13.
    Canadian Medical Association (1987). The elderly: Challenges for today - options for the future. Report of the Committee on Health Care of the Elderly. Canadian Medical Association, Ottawa.Google Scholar
  14. 14.
    Clarfield, A. M., Larson, E. B. (1990). Should a major imaging procedure (CT or MRI) be required in the workup of dementia? An opposing view. J. Family Practice, 31.Google Scholar
  15. 15.
    Katzman, R. (1990). Should a major imaging procedure (CT or MRI) be required in the workup of dementia? An affirmative view. J. Family Practice, 31.Google Scholar
  16. 16.
    Rhymes, J. A., Woodson, C., Sparage-Sachs, R., Cassel, C. (1989). Nonmedical complications of diagnostic workup for dementia. J. Amer. Ger. Soc., 37: 1157–64.Google Scholar

References

  1. 1.
    Transactions of the Clinical Society of London. (1988). Supplement to Volume 21. Report of a Committee of the Clinical Society of London to investigate the subject of myxoedema. London: Longman Green.Google Scholar
  2. 2.
    Hahn, R. D., Webster, B., Weickhardt, G. (1959). Penicillin treatment of general paresis (dementia paralytica). Arch. Neurol., 91: 557–90.Google Scholar
  3. 3.
    Adams, R. D., Fisher, C. M., Hakim, S. (1965). Symptomatic occult hydrocephalus with “normal” cerebrospinal fluid pressure. New Engl. J. Med., 273: 117–26.PubMedCrossRefGoogle Scholar
  4. 4.
    Haase, G. R. (1977). Diseases presenting as, dementia. In: Wells, C. E. (ed) Dementia, 2nd ed. Philadelphia: F. A. Davis, 26–67.Google Scholar
  5. 5.
    Hutton, J. T. (1981). Atrial myxoma as a cause of progressive dementia. Arch. Neurol., 38: 533.PubMedGoogle Scholar
  6. 6.
    Roos, R. P., Johnson, R. T. (1977). Viruses and dementia. Contemp. Neurol. Ser., 15: 93–112.PubMedGoogle Scholar
  7. 7.
    Marsden, C. D., Harrison, M. J. (1972). Outcome of investigation of patients with presenile dementia. Br. Med. J., 2: 249–52.PubMedCrossRefGoogle Scholar
  8. 8.
    Pearce, J., Miller, E. (1973). Clinical Aspects of Dementia. London: Balliere Tindall, 81.Google Scholar
  9. 9.
    Fox, J. H., Topel, J. L., Huckman, M. S. (1975). Dementia in the elderly-a search for treatable illnesses. J. Gerontol., 30: 557–64.PubMedGoogle Scholar
  10. 10.
    Freemon, F. R. (1976). Evaluation of patients with progressive intellectual deterioration. Arch. Neurol., 33: 658–9.PubMedGoogle Scholar
  11. 11.
    Harrison, J. J., Marsden, C. D. (1977). Progressive intellectual deterioration [Letter]. Arch. Neurol., 34: 199.Google Scholar
  12. 12.
    Katzman, R. (1975). Personal Communication. In: Wells, C. E., (ed.) Dementia, 2nd ed. Philadelphia: Davis, F. A., 250.Google Scholar
  13. 13.
    Victoratos, G. C., Lenman, J. A., Herzberg, L. (1977). Neurological investigation of dementia. Br. J. Psychiatry, 130: 131–3.PubMedCrossRefGoogle Scholar
  14. 14.
    Kokmen, E., Okazaki, H., Schoenberg, B. S. (1980). Epidemiologic patterns and clinical features of dementia in a defined U.S. population. Trans. Am. Neurol. Assoc., 105: 334–6.Google Scholar
  15. 15.
    Reifler, B. V., Eisdorfer, C. (1980). A clinic for impaired elderly and their families. Am. J. Psychiatry, 137: 1399–403.PubMedGoogle Scholar
  16. 16.
    Barnes, R. F., Raskind, M. A. (1981). DSM-III criteria and the clinical diagnosis of dementia: a nursing home study. J. Gerontol., 36: 20–7.PubMedGoogle Scholar
  17. 17.
    Garcia, C. A., Reding, M. J., Blass, J. P. (1981). Overdiagnosis of dementia. J. Am. Geriatr. Soc., 29: 407–10.PubMedGoogle Scholar
  18. 18.
    Hutton, J. T. (1981). Results of clinical assessment for the dementia syndrome: Implications for epidemiologic studies. In: Schuman, L. M., Mortimer, J. A. (eds). The Epidemiology of Dementia. New York: Oxford University Press: 62–9.Google Scholar
  19. 19.
    Hutton, J. T. (1981). Senility reconsidered [Letter]. JAMA, 245: 1025–6.CrossRefGoogle Scholar
  20. 20.
    Rabins, P. V. The prevalence of reversible dementia in a psychiatric hospital. Hosp. Community Psychiatry, 32: 490–2.Google Scholar
  21. 21.
    Smith, J. S., Kiloh, L. G. (1981). The investigation of dementia: results in 200 consecutive admissions. Lancet, 1: 824–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Benson, D. F., Cummings, J. L., Tsai, S. Y. (1982). Angular gyrus syndrome simulating Alzheimer’s disease. Arch. Neurol., 39: 616–20.PubMedGoogle Scholar
  23. 23.
    Delaney, P. (1982). Dementia: The search for reversible causes. South Med. J., 75: 707–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Freemon, F. R., Rudd, S. M. (1982). Clinical features that predict potentially reversible progressive intellectual deterioration. J. Am. Geriatr. Soc., 30: 449–51.PubMedGoogle Scholar
  25. 25.
    Maletta, G. J., Pirozzolo, F. J., Thompson, G., Mortimer, J. A. (1982). Organic mental disorders in a geriatric outpatient population. Am. J. Psychiatry, 139: 521–23.PubMedGoogle Scholar
  26. 26.
    Sabin, T. D., Vitug, A. J., Mark, V. H. (1982). Are nursing home diagnosis and treatment adequate? JAMA, 248: 321–2.PubMedCrossRefGoogle Scholar
  27. 27.
    Martin, B. A., Thompson, E. G., Eastwood, M. R. (1983). The clinical investigation of dementia. Can. J. Psychiatry, 28: 282–6.PubMedGoogle Scholar
  28. 28.
    Larson, E. B., Reifler, B. V., Featherstone, H. J., English, D. R. (1984). Dementia in elderly outpatients: A prospective study. Ann. Intern. Med., 100: 417–23.PubMedGoogle Scholar
  29. 29.
    Roca, R. P., Klein, L., McArthur, J. C. (1984). Treatable conditions among demented medical inpatients [Abstract]. Clin. Res., 300A.Google Scholar
  30. 30.
    Folstein, M., Anthony, J. C., Parhad, I., Duffy, B., Gruenberg, E. M. (1985). The meaning of cognitive impairment in the elderly. J. Am. Geriatr. Soc., 33: 228–35.PubMedGoogle Scholar
  31. 31.
    Gilchrist, P. N., Rozenbilds, U. Y., Martin, E., Connolly, H. (1985). A study of 100 consecutive admissions to a psychogeriatric unit. Med. J. Aust., 143: 236–7.PubMedGoogle Scholar
  32. 32.
    Hammerstrom, D. C., Zimmer, B. (1985). The role of lumbar puncture in the evaluation of dementia: the University of Pittsburgh study. J. Am. Geriatr. Soc., 33: 397–400.PubMedGoogle Scholar
  33. 33.
    Larson, E. B., Reifler, B. V., Sumi, S. M., Canfield, C. G., Chinn, N. M. (1985). Diagnostic evaluation of 200 elderly outpatients with suspected dementia. J. Gerontol., 40: 536–43.PubMedGoogle Scholar
  34. 34.
    Renvoize, E. G., Gaskell, R. K., Klar, H. M. (1985). Results of investigation in 150 demented patients consecutively admitted to a psychiatric hospital. Br. J. Psychiatry., 147: 204–5.PubMedCrossRefGoogle Scholar
  35. 35.
    Schoenberg, B. S., Anderson, D. W., Haerer, A. F. (1985). Severe dementia: prevalence and clinical features in a biracial US population. Arch. Neurol., 42: 740–3.PubMedGoogle Scholar
  36. 36.
    Erkinjuntti, T., Wikstrom, J., Palo, J. Autio, L. (1986). Dementia among medical inpatients: Evaluation of 2000 consecutive admissions. Arch. Intern. Med., 146: 1923–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Sayetta, R. B. (1986). Rates of senile dementia, Alzheimer’s type, in the Baltimore Longitudinal Study. J. Chronic Dis., 39: 271–86.PubMedCrossRefGoogle Scholar
  38. 38.
    Pfeffer, R. I., Afifi, A. A., Chance, J. M. (1987). Prevalence of Alzheimer’s disease in a retirement community. Am. J. Epidemiol., 125: 420–36.PubMedGoogle Scholar
  39. 39.
    Rabins, P. V. (1985). The reversible dementias. In: Arie, T. (ed). Recent Advances in Psychogeriatrics. Edinburgh: Churchill Livingstone. 93–102.Google Scholar
  40. 40.
    Wlodarczyk, D. M. (1985). Dementia: guidelines for improving Tx. Geriatrics., 40: 35–45.PubMedGoogle Scholar
  41. 41.
    Hoffman, R. S. (1982). Diagnostic errors in the evaluation of behavioral disorders. JAMA, 248: 964–7.PubMedCrossRefGoogle Scholar
  42. 42.
    National Institute on Aging Task Force (1980). Senility reconsidered: treatment possibilities for mental impairment in the elderly. JAMA, 244: 259–63.CrossRefGoogle Scholar
  43. 43.
    Arie, T. (1973). Dementia in the elderly: diagnosis and assessment. Br. Med. J., 4: 540–3.PubMedCrossRefGoogle Scholar
  44. 44.
    Mulley, G. P. (1986). Differential diagnosis of dementia [Editorial]. Br. Med. J. [Clin. Res.], 292: 1416–8.CrossRefGoogle Scholar
  45. 45.
    Royal College of Physicians Committee on Geriatrics (1981). Organic mental impairment in the elderly: implications for research, education and the provision of services. J. R. Coll. Physicians Lond., 15: 141–67.Google Scholar
  46. 46.
    McIntyre, L., Frank, J. (1987). Evaluation of the demented patient. J. Family Pract., 24: 399–404.Google Scholar
  47. 47.
    Patterson, C. (1986). The diagnosis and differential diagnosis of dementia and pseudo-dementia in the elderly. Can. Fam. Physician, 32: 2607–10.PubMedGoogle Scholar
  48. 48.
    Lister J. Shattuck lecture-The politics of medicine in Britain and the United States. New Engl. J. Med., 315: 168–74.Google Scholar
  49. 49.
    Evans, J. G. (1982). Anglo-American differences in care for the elderly: reflections on a visiting professorship. J. Am. Geriatr. Soc., 30: 34851.Google Scholar
  50. 50.
    Wells, C. E. (1978). Chronic brain disease: An overview. Am. J. Psychiatry, 135: 1–12.PubMedGoogle Scholar
  51. 51.
    McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34: 939–44.PubMedGoogle Scholar
  52. 52.
    Blass, J. P., Barclay, L. I. (1985). New developments in the diagnosis of the dementias. Drug Develop. Res., 5: 39–58.CrossRefGoogle Scholar
  53. 53.
    Consensus conference: differential diagnosis of dementing diseases (1987). JAMA, 258:3411–6.Google Scholar
  54. 54.
    Dementia in Later Life: Research and Action. (1986). Report of a WHO Scientific Group on Senile Dementia. No. 730. Geneva: World Health Organization.Google Scholar
  55. 55.
    Cowell, D. D. (1983). Senile dementia of the Alzheimer’s type: A costly problem [Editorial]. J. Am. Geriatr. Soc., 31: 61.PubMedGoogle Scholar
  56. 56.
    Beck, J. C., Benson, D. F., Scheibel, A. B., Spar, J. E., Rubenstein, L. Z. (1982). Dementia in the elderly: The silent epidemic. Ann. Intern. Med., 97: 231–41.PubMedGoogle Scholar
  57. 57.
    Sourander, P., Sjogren, H. (1970). The concept of Alzheimer’s disease and its clinical implications. In: Wolstenholme, G. E. W., O’Connor, M. (eds). Alzheimer’s and Related Conditions. London: Churchill, 11–36.Google Scholar
  58. 58.
    Tomlinson, B. E., Blessed, G., Roth, M. (1970). Observations on the brains of demented old people. J. Neural. Sci., 11: 205–42.CrossRefGoogle Scholar
  59. 59.
    Malamud, N. (1972). Neuropathology of organic brain syndromes associated with aging. In: Gaitz, C. M. (ed). Aging and the Brain. New York: Plenum, 63–87.Google Scholar
  60. 60.
    Todorov, A. B., Go, R. C., Constantinidis, J., Elston, R. C. (1975). Specificity of the clinical diagnosis of dementia. J. Neurol. Sci., 26: 81–98. 61.CrossRefGoogle Scholar
  61. 61.
    Ojeda, V. J., Mastaglia, F. L., Kakulas, B. A. (1986). Causes of organic dementia: a necropsy survey of 60 cases. Med. J. Aust., 145: 69–71.PubMedGoogle Scholar
  62. 62.
    Kokmen, E., Of ford, K. P., Okazaki, H. (1987). A clinical and autopsy study of dementia in Olmsted County, Minnesota, 1980–81. Neurology, 37: 426–30.PubMedGoogle Scholar
  63. 63.
    Shaw, G. M., Harper, M. E., Hahn, B. H. (1985). HTLV-III infection in brains of children and adults with AIDS encephalopathy. Science, 227: 177–82.PubMedCrossRefGoogle Scholar
  64. 64.
    Diagnostic and Statistical Manual of Mental Disorders III. (1980). Washington, D.C.: American Psychiatric Association.Google Scholar
  65. 65.
    Nott, P. N., Fleminger, J. J. (1975). Presenile dementia: the difficulties of early diagnosis. Acta Psychiatr. Scand., 51: 210–7.PubMedCrossRefGoogle Scholar
  66. 66.
    Ron, M. A., Toone, B. K., Garralda, M. E., Lishman, W. A. (1979). Diagnostic accuracy in presenile dementia. Br. J. Psychiatry, 134: 161–8.PubMedCrossRefGoogle Scholar
  67. 67.
    Wilson, D. B., Guyatt, G. H., Streiner, D. L. (1987). The diagnosis of dementia. Can. Med. Assoc. J., 137: 625–9.Google Scholar
  68. 68.
    Cummings, J., Benson, F., Loverme, S., Jr. (1980). Reversible dementia: illustrative cases, definition, and review. JAMA, 243: 2434–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Duckworth, G. S., Ross, H. (1975). Diagnostic differences in psychogeriatric patients in Toronto, New York and London, England. Can. Med. Assoc. J., 112: 847–51.PubMedGoogle Scholar
  70. 70.
    Smith, J. S., Kiloh, L. G., Ratnavale, G. S., Grant, D. A. (1976). The investigation of dementia: the results in 100 consecutive admissions. Med. J. Aust., 2: 403–5.PubMedGoogle Scholar
  71. 71.
    Mortimer, J. A., Schuman, L. M., French, L. R. (1981). Epidemiology of dementing illness. In: Schuman, L. M., Mortimer, J.. The Epidemiology of Dementia, New York: Oxford University Press, 323.Google Scholar
  72. 72.
    Clarfield, A. M., Friedman, R. (1985). Survey of the age structure of “age-relevant” articles in four general medical journals. J. Am. Geriatr. Soc., 33: 773–8.PubMedGoogle Scholar
  73. 73.
    Sackett, D. I., Haynes, R. B., Tugwell, P. (1985). Clinical Epidemiology: A Basic Science for Clinical Medicine. Boston: Little Brown and Co., 289–90.Google Scholar
  74. 74.
    Cox, S. (1983). Comments on “unsolved issues” and reversible dementia [Letter]. J. Am. Geriatr. Soc., 31: 126.PubMedGoogle Scholar
  75. 75.
    Wolff, M. L. (1982). Reversible intellectual impairment: an internist’s perspective. J. Am. Geriatr. Soc., 30: 647–50.PubMedGoogle Scholar
  76. 76.
    Rudnick, K. V., Sackett, D. L., Hirst, S., Holmes, C. (1977). Hypertension in a family practice. Can. Med. Assoc., 117: 492–7.Google Scholar
  77. 77.
    Sackett, D. L. (1979). Biases in analytic research. J. Chronic Dis., 32: 5163.CrossRefGoogle Scholar
  78. 78.
    Larson, E. B., Reifler, B. V., Sumi, S. M., Camfield, C. G., Chinn, N. M. (1986). Diagnostic tests in the evaluation of dementia: a prospective study of 200 elderly outpatients. Arch. Intern. Med., 146: 1917–22.PubMedCrossRefGoogle Scholar
  79. 79.
    Reisberg, B. (1983). Clinical diagnosis and differential diagnosis of Alzheimer’s disease and related disorders. In: Reisberg, B. (ed). Alzheimer’s Disease. New York: The Free Press, 173–87.Google Scholar
  80. 80.
    Williamson, J., Stokoe, J. H., Gray, S. (1964). Old people at home: their unreported needs. Lancet, 1: 117–20.Google Scholar
  81. 81.
    McCartney, J. R., Palmateer, L. M. (1985). Assessment of cognitive deficit in geriatric patients: a study of physical behavior. J. Am. Geriatr. Soc., 33: 467–71.PubMedGoogle Scholar
  82. 82.
    Schoenberg, B. S. (1986). Epidemiology of Alzheimer’s disease and other dementing illnesses. J. Chronic Dis., 39: 1095–104.PubMedCrossRefGoogle Scholar
  83. 83.
    Wells, C. E. (1979). Pseudodementia. Am. J. Psychiatry, 136: 895–900.PubMedGoogle Scholar
  84. 84.
    Reding, M., Haycox, J., Wigforss, K., Brush, D., Blass, J. P. (1984). Follow-up of patients referred to a dementia service. J. Amer. Geriatr. Soc., 32: 265–8.Google Scholar
  85. 85.
    Reifler, B. V. (1982). Arguments for abandoning the term pseudodementia. J. Am. Geriatr. Soc., 30: 665–8.PubMedGoogle Scholar
  86. 86.
    Reifler, B., Larson, E., Hanley, R. (1982). Coexistence of cognitive impairment and depression in geriatric outpatients. Am. J. Psychiatry, 139: 623–6.PubMedGoogle Scholar
  87. 87.
    Mold, J. W., Stein, H. F. (1986). The cascade effect in the clinical care of patients. New Engl. J. Med., 314: 512–4.PubMedCrossRefGoogle Scholar
  88. 88.
    West, L. J., Maxwell, D. S., Noble, E. P., Solomon, D. H. (1984). Alcoholism. Ann. Intern. Med., 100: 405–16.PubMedGoogle Scholar
  89. 89.
    Blume, S. B. (1983). Is alcoholism treatment worthwhile? Bull. N.Y. Acad. Med., 59: 171–80.PubMedGoogle Scholar
  90. 90.
    Vaillant, G. E., Clark, W., Cyrus, C. (1983). Prospective study of alcoholism treatment: Eight year follow-up. Am. J. Med., 75: 455–63.PubMedCrossRefGoogle Scholar
  91. 91.
    Meyer, J. S., Judd, B. W., Tawakina, T., Rogers, R. L., Mortel, K. F. (1986). Improved cognition after control of risk factors for multi-infarct dementia. JAMA, 256: 2203–9.PubMedCrossRefGoogle Scholar
  92. 92.
    LarocheIle, P. (ed) (1985). Report of the Consensus Development Conference in the Management of Hypertension in the Elderly in Canada. Montreal: Canadian Hypertension Society. Google Scholar
  93. 93.
    Amery, A., Birkenhager, W., Brixko, R. (1986). Efficacy of antihypertensive drug treatment according to age, sex, blood pressure and previous cardiovascular disease in patients over the age of 60. Lancet, 2: 589–92.PubMedCrossRefGoogle Scholar
  94. 94.
    Martin, D. C., Miller, J., Kapoor, M., Karpf, M. (1985). A test of diagnostic strategies in senile dementia. [Abstract]. Clin. Res., 33: 726A.Google Scholar
  95. 95.
    Martin, D. C., Miller, J., Kapoor, W., Karpf, M., Boller, F. (1987). Clinical prediction rules for computed tomographic scanning in senile dementia. Arch. Int. Med., 147: 77–80.CrossRefGoogle Scholar
  96. 96.
    Larson, E. G., Buchner, D. M., Uhlmann, R. F., Reifler, B. V. (1986). Caring for elderly patients with dementia [Editorial]. Arch. Intern. Med., 146: 1909–10.PubMedCrossRefGoogle Scholar
  97. 97.
    Uncovering physical illness in elderly patients with dementia [Editorial] (1977). Br. Med. J., 2: 1499–1500.Google Scholar
  98. 98.
    Summers, W. K., Majovski, L. V., Marsh, G. M., Tachiki, K., Kling, A. (1986). Oral tetrahydroaminoacridine in long-term treatment of senile dementia, Alzheimer’s type. New Engl. J. Med., 315: 1241–5.PubMedCrossRefGoogle Scholar
  99. 99.
    Davis, K. L., Mohs, R. C. (1986). Cholinergic drugs in Alzheimer’s disease [Editorial]. New Engl. J. Med., 315: 1286–7.PubMedCrossRefGoogle Scholar
  100. 100.
    Pirozzolo, F. J., Hermann, N., Small, G. W., Tariot, P. N., (1987). Oral tetrahydroaminoacridine in the treatment of senile dementia, Alzheimer’s type [Letters]. New Engl.J. Med., 316: 1603–5.CrossRefGoogle Scholar
  101. 101.
    Arie, T. (1986). Management of dementia: A review. Br. Med. Bull., 42: 91–6.PubMedGoogle Scholar
  102. 102.
    Cassel, C. K., Jameton, A. L. (1981). Dementia and the elderly: an analysis of medical responsibility. Ann. Intern. Med., 94: 802–7.PubMedGoogle Scholar
  103. 103.
    Zimmer, A. W., Calkins, E., Hadley, E., Ostfeld, A. M., Kaye, J. M. Kaye, D. (1985). Conducting clinical research in geriatric populations. Ann. Intern. Med., 276–83.Google Scholar

Copyright information

© Plenum Press, New York 1990

Authors and Affiliations

  • A. Mark Clarfield
    • 1
    • 2
  1. 1.Division of Geriatrics Sir Mortimer B. DavisJewish General HospitalMontrealCanada
  2. 2.McGill UniversityMontrealCanada

Personalised recommendations