This study aimed to determine the effectiveness of group music therapy to improve the depression and cognitive function of elderly persons with dementia.

This was a randomized clinical trial design with permuted block randomization.

Three nursing homes in Taiwan.

Of the 104 elderly persons with dementia randomly assigned to the experimental or control group, 100 completed the study: 49 in the experimental group and 51 in the control group.

The experimental group received 12 sessions of group music therapy of 30 min each. the control group maintained routine activities of daily living.

Groups were compared for depression and cognitive function before the intervention, at the 6th and 12th session and one month after cessation. Generalized estimating equations (GEEs) were used to estimate repeated effects of music therapy.

Results indicated that: 1) depression decreased at the 12th session (P < 0.001); 2) cortisol level was not significant decreased in the experimental and control group after music therapy; and 3) cognitive function improved significantly at 6th, 12th session, and one month follow-up (P < 0.044; P < 0.001; P < 0.026). Music therapy is more appropriate for mild and moderate dementia. the music therapy had more impact on dementia elders’ function of recall than on orientation, registration, attention and calculation, language and spatial.

Depression in elderly with dementia can be decreased and their cognitive function improved slightly through group music therapy. the mechanism behind the diminished cortisol levels in the effects of music therapy in dementia remains to be determined.

This study investigated the discrepancy between patients' and caregivers' ratings of patients' QoL in a cross-sectional study. the focus was on the main predictors of patients' and caregivers' QoL ratings, with an emphasis on awareness of disease, cognitive function, depressive status, functional activities and caregiver burden.

Forty-one patients and their caregivers were recruited from a center for Alzheimer's disease. the quality of life was assessed using the Alzheimer's disease Scale for Patients and Caregivers, the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia, the Mini-Mental State Examination, the Clinical Dementia Rating, the Cornell Scale for Depression in Dementia, the Pfeffer Functional Activities Questionnaire and the Zarit Burden Interview.

Patients reported a positive QoL when awareness of disease was impaired (p < 0.01). Caregivers' ratings were correlated with patients' QoL perception (p < 0.01) and patients' depressive status (p < 0.001). A discrepancy between patients' and caregivers' ratings was reported in terms of energy, living situation, memory, friends, chores and fun. Regression analysis suggested that awareness of disease and depressive status explained patients' Quality of life in Alzheimer's disease (QoL-AD) (31%). the educational status of the caregiver, caregiver burden, self-reported QoL-AD and patients' depressive status were all predictors of proxy QoL-AD (79%).

The quality of life in Alzheimer's disease patients is not directly correlated with cognition. Awareness of disease and depressive status impact self-reported QoL-AD. A relevant measure of awareness must be included in all assessments that target the well-being of dementia patients.

Alzheimer's Disease affects the total quality of the marital relationship and the couple's sexual intimacy.

To study changes in sexual activity and satisfaction between AD patients and their spouses.

Couples whose spouses were diagnosed with mild and moderate AD (n = 36) were included. Instruments:MMSE, CDR, APID, CORNELL, Questionnaire on Sexual Experience and Satisfaction, ZARIT.

Presence of sexual activity was reported by patients (63.8%) and spouses (55.5%); 34.7% of the male patients and 34.0% of the female patients reported sexual dissatisfaction. Interruption of the sexual activity was reported by 44.4% of the spouses and by 36.8% of the patients. there was no significant difference between CDR1 and CDR2 patients’ sexual satisfaction (p = 0.47). Spouses were sexually dissatisfied with significant statistical differences between severity of disease groups (p = 0.049). Spouses presented a moderate rate of burden of care (48.77 ± 20.13). Feelings of burden related to sexual dissatisfaction were reported by 37.5% of the spouses. Awareness of disease was impaired in 72.2% of AD patients. there was no significant relationship between sexual dissatisfaction and awareness of disease.

AD has an impact in couples’ sexual activity and satisfaction. Spouses of mild patients AD are more sexual dissatisfied than the moderate group.

To gain insight into facilitators and barriers for the integration of community dementia care.

Qualitative focus group discussions and semistructured interviews.

Community care in a period in which the National Dementia Program stimulated integration of dementia care; at the same time, a new law stimulated market mechanism in care.

Professionals involved in the development of five dementia networks.

We conducted three focus group interviews and three face-to-face interviews with 17 professionals from various disciplines involved in the National Dementia Program. the data were analyzed using the grounded theory approach.

Analysis revealed facilitators and barriers affecting integration of dementia care. the facilitators were the intrinsic motivation to collaborate on improving dementia care, client-centeredness of the improvement projects, positive team climate, sufficient financial support and embedding of the improvement projects, and the well-structured, uniform format of the National Dementia Programme. At the individual level, the main barriers were demotivation, sub-optimal professional participation, insufficient funding of improvement projects, and market mechanisms and competition.

We hypothesize that societal trends strongly influence the level of inter-organisational collaboration and individual commitment, thereby modulating the effectiveness of integrative efforts in dementia care.

The cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-Cog) has been established internationally as an instrument for the assessment of treatment efficacy and cognitive performance in clinical trials. there is no data about the psychometric characteristics of ADAS-Cog in Hungarian sample.

This study is a part of the Hungarian standardization process of ADAS-Cog. It is crucial to examine the cognitive performance of patients with pseudodementia caused by depression (D) because of its’ similarities with Alzheimer's disease (AD). the objective of the study was to analyze the characteristics of the cognitive subscale for further validation purposes.

The study aimed at analyzing the ADAS-Cog performance of patients with D and AD in a Hungarian sample to make future studies more accurate through more exact differentiation between the two diseases.

Forty-seven normal elderly control (CG) subjects, 66 AD patients and 39 patients with D participated in the study. the mental state and the severity of depressive symptoms of the participants were assessed by the means of ADAS-Cog, Mini Mental State Examination (MMSE) and Beck Depression Inventory.

While the performance of the two patient groups differed from the CG, the two groups are overlapping and the characteristic of the ROC curve indicates that the differentiation is mediocre (AUC = 0.8 Sensitivity = 62.1%, Specificity = 89.7%).

The results suggest that pseudodementia should be considered during the design of studies using ADAS-Cog. as the cognitive subscale is not suitable to differentiate between AD and pseudodementia additional measures like BDI should be administered.

Dementia paralytica, a late neuropsychiatric complication of syphilis, was common in Europe at the beginning of the 20th century. in the course of the subsequent century, the number of patients decreased dramatically, partly due to improved treatment options. One of the great therapeutic breakthroughs was the discovery of malaria fever therapy by Wagner von Jauregg.

This retrospective cohort-study was designed to detect prognostic factors regarding the treatment of dementia paralytica with malaria fever therapy.

Inpatients of the Vincent van Gogh psychiatric hospital in Venray were included in this study if they had a discharge diagnosis of dementia paralytica (general paralysis of the insane) and had been treated with malaria fever therapy in the period from 1907 to 1970. Patients were identified using annual reports and death registries from the hospital. Each patient's clinical record was reviewed for demographic, clinical, therapeutical and laboratory data. We measured survival after malaria fever therapy. Treatment response was categorized as: complete remission, incomplete remission but no hospitalization required, incomplete remission and permanent hospitalization required, unimproved or death during or shortly after treatment. the cause of death was classified as related or not related to dementia paralytica.

Preliminary results suggest that 70 % of the patients were male. Many patients died within 2 months of hospitalisation, but some survived for more than 20 years.

Further analysis is currently being done and definite results and conclusions will be presented at the meeting.

CJD is a rare dementia characterized by a rapidly progressive course. Psychiatric symptoms, including depression and personality change, occur early in the clinical course in about a third of patients, being estimated in some studies that 10% of patients are first admitted to psychiatric wards. Psychiatric symptoms associated with CJD have often lead to erroneous initial diagnoses of functional psychosis, depressive pseudodementia, or hysteria.

Analysis of the psychiatric symptoms does not suggest specific features that rapidly allow the differentiation from more common psychiatric disorders, although the occurrence of associated persistent sensory symptoms may raise the possibility of this diagnosis. Later, the characteristic rapidly progressive neurological impairment is decisive in the affirmation of the diagnosis of CJD.

Alzheimer's disease (AD) is the most frequent neurodegenerative disease, characterized by progressive decline in variety of higher brain functions - memory, orientation, and thinking. According to increasing evidences, mitochondrial insufficiencies contribute to pathology of AD; changes were described in AD brains, blood cells and human fibroblasts.

On molecular level, oxygen and glucose metabolism is altered and energy metabolism is impaired.

Mitochondrial abnormalities and alterations in mitochondrial enzymes, especially complex I and cytochrome c oxidase, were observed. However, the cause and important aspects of AD mechanism have not yet been sufficiently clarified.

The aim of our study was to find whether kinetics of oxygen consumption is modified in AD patients. Further, we afford to suggest parameters that could be suitable as AD markers.

AD patients and healthy control group were included in the study. Respiratory rate of mitochondria, as measure of total activity of the system of oxidative phosphorylation (OXPHOS), was measured in mitochondria using oxygraph with Clark-type electrodes. High resolution respirometry was performed in intact as well as in permeabilized platelets.

Our results indicate significantly lower respiratory rate in intact platelets as well as lower respiratory capacity of electron transfer system in patients with AD compared to controls.

We propose that decrease in oxygen consumption may participate in pathophysiology of AD, and respiratory rate in platelets could be AD marker.

The diagnostics of the psychical state of an elderly person is very difficult. At the early stage of a disease people frequently think of the symptoms of the dementia and those of the depression like characteristics of the physiological senium. as a result, at the next stage the dementia and depression differential diagnostics and the treatment are more difficult.

231 patients at age 70 and more are examined.

Frequency and comorbidity of dementia and depression in elderly

The examination of cognitive function included MMSE scale and Drawing Clock Test. the application Zung and Beck scales of depression for finding depressive symptoms in an elderly patient with cognitive dysfunction is not adequate.

Mild cognitive dysfunction was found in 118 cases, dementia - in 113 cases. 11 patients with disagreement of results MMSE scale and drawing clock test were included into the group with mild cognitive dysfunction. Depressive disorders was found in 88 cases. Depressive symptoms were detected in 88 cases. the prevailing depressive disorders among patients with mild cognitive dysfunction were of light and middle. Along with the properties of depression typical of the dementia patients, psychogenic depression was also observed.

Types of interrelations between depressive and cognitive disorders are: 1) depressive disorders are similar to cognitive dysfunction; 2) cognitive disfunction is masked by depressive symptoms; 3) depressive disorders are not diagnosed with dementia patient timely.

The Confusion Assessment Method/CAM (Inouye et al, 1990) is a widely used delirium screening instrument, based on DSM-III-R criteria. It can be readily applied in routine clinical settings by non-psychiatric medical or nursing staff.

To present the translation and cultural adaptation process as well as preliminary results of a pilot-study of the Portuguese version of CAM.

The translation process of CAM was carried out according to guidelines suggested by the International Society for Pharmacoeconomics and Outcomes Research (Wild et al, 2005). in this process, the inter-rater reliability was tested.

After that, a pilot-study was carried out with elderly patients (≥65 years), within 24 h after of admission into two sub-intensive care units (Emergency and Surgical Services) of S. João Hospital, in Porto. Patients in mutism or who scored ≥11 on the Glasgow scale were excluded. A blinded assessment was conducted by a psychiatrist, as the reference rater using the Delirium criteria of DMS-IV-TR and by a psychologist, using the Portuguese translation of CAM.

The CAM was successfully translated by the Portuguese team. for inter-reliability assessment, 20 elderly patients were included. Overall inter-rater reliability was very good (Kappa > 0.81). Sensitivity and specificity of Portuguese version, as well as the convergent validity will be presented.

The translation showed good correlation with the original English version developed by Inouye. This study also showed a high inter-rater reliability using this translation between researchers. Therefore, the Portuguese version of CAM could be applicable in Portuguese Emergency and Surgical Services.

Dysexecutive syndrome (DS) is characterized by impairments in executive function and emotional and behavioural disturbances. Available pharmacological interventions for cognitive enhancement, have limited efficacy in improving the symptoms while metylphenidate is known to be effective in Attention Deficit/Hiperactivity Disorder, a condition characterized, as in DS, by prefrontal cortico-subcortical dysfunction.

To report a case of successfull management of severe DS with methylphenidate.

Evaluate the effectiveness of methylphenidate on DS.

A 49-years-old male patient with severe vascular DS, was started on methylphenidate 10 mg daily (increased to 36 mg id).Patient was evaluated with Mini-Mental State (MMS), Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) at T0 (before intervention), T1 (after 48 h), T2 (after 6 months) and T3 (after 18 months). Single photon emission computed tomography (SPECT) was undertaken at T0 and T3.

A rapid and sustained improvement was observed, with a 23% improvement in MMS), decrease of 83% in CGI and a 24.5% reduction in total BPRS, at T1 with beneficial effects persisting at T3. Brain SPECT at T3 revealed an improvement of perfusion deficits documented at T0.

Methylphenidate rapidly improved the symptoms of DS, and the effect persisted over 18 months with an associated improvement in brain perfusion.

Methylphenidate can thus be a promising therapeutic choice in cases of DS.

Balkan Endemic Nephropathy (BEN) is a chronic tubulo-intestinal disease of unknown etiology with a specificity of appearance in the Danube Basin (Croatia, Bosnia and Herzegovina, Serbia, Romania and Bulgaria).

To prove the difference in frequency and severity of various forms of dementia (Alzheimer's-AD, Vascular-VD and Mixed-MD) in patients with BEN and other forms of chronic renal insufficiency (CRI).

The research was conducted among 753 patients receiving dialysis, which are divided into two groups: experimental, which included subjects with BEN (n = 348) and control, which consisted of patients suffering from other types of CRI (n = 405). for this longitudinal study were used the following instruments: BHRRQ, EPQ, BAI, HDRS and MMSE. the results obtained with univariate and multivariate analysis.

Multivariate analysis found significant correlation of dementia with the age, years of receiving dialysis, compliance, TIA/RIND, earlier and current learning and psychoticism. BEN group: AD = 0.7%, VD = 4.1% and MD = 1.8%. Other forms of CRI: AD = 0.4%, VD = 2.7% and MD = 1.5%. Dialysis disequilibrium syndrome (DDS) has not been proven in the results.

There is a significant difference in the frequency and severity of dementia that develops in patients with BEN than in those with other forms of CRI. the most common form of dementia is vascular with higher incidence in BEN than other types of CRI. there is no evidence which connects dementia with DDS.

Cognitive impairment and loss of functionality are key characteristics of dementia and also highly prevalent among patients with serious mental illness. Our study reports on the prevalence of dementia and the relationship between cognitive decline, behavioral and social functioning disturbances, lifestyle/ physical health parameters and the pharmaceutical approaches, in an elderly population of the psychiatric hospital of Attica.

103 patients, aged 55 years or more, with diagnosis of Schizophrenia/other psychotic disorders, Mood disorders, and mental disorders due to a general medical condition (DSM-IV-TR) participated. Dementia was also defined according to DSM-IV-TR. Data collection was through their medical records and scales (Mini Mental State Examination, Clock Drawing Test, Global Deterioration Scale, Katz Index of Independence in Activities of Daily Living, Neuropsychiatric Inventory). All variables were statistically analyzed using the SPSS.

Of the sample of 103 participants, 35.9% men, 64.1% women (mean age of 71), 60.2% had Schizophrenia, 7.8% Mood disorder, 32% Mental disorders due to a general medical condition. Dementia was diagnosed in 42 patients. 43,7% had severe daily skills dysfunction. Only 12,6% had no concomitant physical illness. Although they all had cognitive impairment, only 1/3 were treated with cognitive enhancers.

Long term mental disorder and long term hospitalization lead to severe deterioration of both cognitive function and daily skills abilities. Along with early screening for dementia, psychogeriatric patients need specific therapeutic approaches, promotion of favourable physical profile and amelioration of the consequences of the long term medication in their fragile health.

Mild cognitive impairment(MCI) is considered to be a potential transitional stage between normal cognitive function and dementia.

To determine comparatively the outcome of patients treated with different therapies.

There were included 193 subjects with MCI, aged over 65. They were evaluated after 6 months, 1 year and 2 years of treatment using Mini Mental State Examination (MMSE) and clock test.

1. Group A -43 patients treated with piracetamum(daily dose:1600 mg).

2. Group B that comprises 44 patients diagnosed with MCI treated with rhodiola rosea, 2 capsules/day.

3. Group C -41 patients which were treated with antioxidant agents(vitaminE 800ui/day).

4. Group D -36 subjects treated with piracetamum associated with rhodiola rosea and vitamin E.

5. Group E -29 patients without treatment.

Mean of MMSE score at inclusion was 24,49 (SD = 2,1). After 6 months of treatment MMSE score improve in groups treated with 1,35 points in group A, 1,41 for group B, 1,12 points for group C, 1,18 points in group D and in group E we observed an impairment with 0,52 points. in groups A, B, C and D after 1 year of treatment the improvement is with 2,07; 2,03, 2,68 and 3,03 points comparing with the impairment in group E of 1,69 points. Evaluation after 2 years of treatment show a better improvement for group D (3,3 points), followed by group C (2,63 points), group B (2,43 points) and group A (2,23 points) and a greater impairment in group E (2,49 points).

MCI has a better evolution in group treated with a combined therapy comparing with groups treated with monotherapy and in group E the patients present an impairment of cognitive function.

It has been suggested that Music Therapy (MT) may be a suitable treatment modality for behavioural and psychological symptoms of dementia (BPSD). A Cochrane review in 2004 found the methodological quality of existing studies was generally poor, and better quality research was required.

This review aimed to examine the evidence since 2004 to determine whether more rigorous studies have been published.

A systematic review of the literature was conducted. MEDLINE, PsycINFO and the Cochrane Library were searched for randomized controlled trials (RCTs) of MT interventions in patients with dementia, between July 2004 and February 2011. Six studies, with 262 participants, reported outcomes in BPSD.

The value of MT depends on intervention type and symptom targeted. Two studies evaluated interactive music interventions, focusing on patient-therapist relationships. Both showed significant reductions in BPSD (measured by the Neuropsychiatric Inventory), specifically improvements in delusions, agitation and anxiety. the remaining studies examined passive music listening interventions, with varied results. Two examined individual music listening programmes, showing significant improvements in anxiety, depression and physical agitation, but no effect on verbal agitation. Two others, looking at group therapy, also had mixed success. A music and movement intervention showed improvements in agitated behaviours. However, a group-singing programme had no significant effect on agitation/anxiety.

The trials included in this review were high quality single-blind RCTs, leading to reduced bias and stronger evidence base. Although all studies reported positive effects from music, the most significant results came from interactive, targeted programmes, focusing on therapeutic relationships.

Syphilis of the nervous system is a chronic disease with light initial manifestations and severe late after-effects. in Ukraine cases with neurosyphilis have been increased since 2003 year. Clinical symptoms of neurosyphilis have been changed. Symptoms of the initial forms of neurosyphilis concealed different somatic diseases. That is why the patient with neurosyphilis become patients of any other specialists such as an ophthalmologists, a therapeutists, a neurologists, etc.

Aim to study clinical and diagnostic particulars of neurosyphilis psychiatric patients.

Psychiatric patients with neurosyphilis in period from 2003 through 2011.The detailed analysis of patients information was done. It included different types of test, investigations and anamnesis. Among them are: psychopathologic test, CT, ES, the serologic results of blood, the investigations of liquors (the cytosis one, the albumen one, the results of Zax-Vitebsky, Kan reactions) and the neurologic examination in the process of treatment.

Revealed prevalence of initial forms of neurosyphilis (mesenkhimal) over the late forms (parenchymatous). the late forms of neurosyphilis take 23,40% among the general number of patients. Dementia form takes 60,00%, the depressive - 20,00%, the expansive one −10,00% and other forms 10,00%. there are some factors of risk that actually influence the development of neurosyphilis. there are alcohol dependence, trauma of the skull and brain, general immune deficiency and the low social standard of living.

Revealed increasing number of latent forms of syphilis which is consequently transferring into late forms of neurosyphilis (p > 0,001).

Dementia is a neurological disease mainly characterized by clinically significant cognitive deficit which includes memory. Behavioral changes may occur and lead to an autonomy loss and a decreased capacity to perform daily professional and social activities. Disease-related undernutrition leads to an increased number of clinical complications as with a negative outcome in the physical and psychological status. Hospitalization can worsen the status. the Full Mini Nutritional Assessment (MNA)® is the golden standard for nutritional status evaluation and it is validated for Alzheimer Disease (AD).

Undernutrition in AD patients has been also related to significant weakness, depression, increased susceptibility to other illness.

Evaluate the Nutritional Status of the hospitalized elderly dementia patients in the Geriatric Ward - Hospital de Magalhães Lemos and it‘s relation with calf circumference.

Cross-sectional study made between February to May of 2011. Full MNA® was applied. Furthermore, the patients were subjected to weight, height, calf circumference and mid-arm circumference measurements and the body mass index was calculated.

22 patients were evaluated of which 31.8% were male and 68.2% female.Mean age was 74.9 (8.2) years.Full MNA® revealed that 45.5% of the elderly dementia people were at risk of malnutrition, 4.5% did not show nutritional risk and 50% was malnourished.The calf circumference equal or superior to 31 cm showed to be more representative with 54.5%, while inferior to 31 cm showed 45.5%.

This study revealed the major importance of assessing the nutritional status and the need to use the calf circumference as a parameter for that evaluation.

Recent advances in biomarker technology have allowed for the development of highly predictive tests for Alzheimer's disease (AD) when combined with standard psychometric tests. Current research in AD utilizes the ADAS-Cog and/or the MMSE as standard measures; they do not exclusively address the specific deficits expected in an amnesic syndrome of the hippocampal type as express with AD.

Because episodic memory degradation is most strongly predictive of conversion from mild cognitive impairment (MCI) to AD, a clinical measure targeting this deficit is warranted.

To utilize current knowledge of neural correlates of different stages of episodic memory function and their modulation by AD to develop a psychometrically sound instrument.

The authors developed a brief scale that captures registration, storage and retrieval of information along four identified domains of episodic memory in AD. A second stage was to confirm BEMA in institutionalized subjects, and assess reliability and validity.

Preliminary results indicate good test-retest reliability and adequate sensitivity and specificity. the BEMA was positively and significantly correlated with other measures of episodic memory. the [insert scale name or abbreviation] yields a total score, scores for 3 lifetime periods and the duration of episodic memory impairment.

Findings suggest that a richer understanding of the memory deficits in AD can lead to the development of an instrument which taps different aspects of episodic memory function. This scale can aid in the screening, assessment and treatment of early AD and complement the newly developed one-plus-one strategy.