Instruments for the functional assessment of older patients

Article Abstract:

Comprehensive functional assessment of elderly patients is an approach that evaluates abilities and needs in physical, cognitive, emotional, and social, categories. Several test instruments (structured approaches) are evaluated for their use in clinical practice. Before one can be selected, the clinician should set a goal that such an instrument can help toward, such as establishing base-line descriptions or screening for risk factors. In general, these instruments are not helpful in diagnosis, which remains a clinical judgment. Instruments should have proven validity (accuracy in measuring what they purport to measure) and reliability (consistency among different interviewers). They should detect changes in the patient's condition and should be broad enough to detect important changes, while brief enough to be manageable in the clinic. ADL (activities of daily living) scales measure patients' abilities to care for themselves and do not include other, less basic, functions. Assessment of a wider range of capabilities, such as climbing stairs or lifting heavy objects, is also meaningful. Lists of instruments used to assess ADL, cognitive function, and emotional status are provided. Social activities and support systems available to the patient are also important for a clinician to understand. The instruments described can be used by a team of clinicians, including a physician, a nurse, and a social worker, but physicians can also use them alone. Since clinicians tend to be relatively unskilled at predicting patients' levels of functioning, development of skill in using these instruments is recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Ability, Aptitude tests

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Immunologic treatment of Alzheimer's disease

Article Abstract:

Vaccinating people against amyloid precursor protein may reveal whether abnormal deposits of amyloid in the brain are the primary cause of Alzheimer's disease. This hypothesis is supported by research showing that many people with hereditary forms of Alzheimer's disease have a mutation in the gene for amyloid precursor protein. However, other studies have shown that people who die with no evidence of Alzheimer's also have amyloid deposits in their brains. In a 1999 study, mice who were vaccinated with a fragment of amyloid precursor protein did not develop amyloid deposits in their brains.

Care and treatment, Research, Alzheimer's disease, Immunotherapy

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"Silent" strokes and dementia

Article Abstract:

A study published in 2003 shows that dementia may be caused by little 'mini-strokes' that have no symptoms. This type of dementia is often called multi-infarct dementia. If this is true, then people whose brain scans show evidence of small strokes should be treated to prevent additional strokes.

Health aspects, Editorial, Causes of, Stroke (Disease), Stroke, Dementia

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