Ewald W. Busse

Studies in the processes of aging: Electroencephalographic findings in 400 elderly subjects

Abstract 1. 1. Electroencephalograms were obtained on 400 subjects over the age of 60 as part of a project dealing with aging of the central nervous system. 2. 2. One hundred senile patients, without evidence of gross focal neurological disease revealed that 22 per cent had normal records with a preponderance of diffuse and mixed abnormalities. 3. 3. In 145 volunteers from the community without neurological disease, a high percentage of focal disturbances were found, and a gradient of decreasing EEG abnormality of all types was noted with higher socio-economic levels. Focal disturbances alone did not seem to cause psychological impairment. 4. 4. Psychological test data correlate diffuse and mixed EEG abnormalities with the greatest degree of psychological deterioration. 5. 5. Forty-five psychiatric patients with no evidence of brain damage revealed patterns of electroencephalographic abnormalities similar to the community group volunteers, 60 per cent of their records being normal. Diffuse fast wave disturbances were relatively more frequent among the abnormalities seen. 6. 6. Ninety-four neurological cases showed the expected low incidence in normal records and a heavy preponderance of focal disturbances. 7. 7. A gradient of decreasing normal records was noted in progressively older decades. Diffuse dysrhythmias which followed this trend were due to slow wave disturbances. The incidence of focal records did not appear to change in succeeding decades, but a definite increase in the proportion of severe foci was noted in progressively older decades. 8. 8. Diffuse fast wave disturbances were not frequent, and showed a tendency to decrease in older patients, as did the proportion of severe fast disturbances. No fast wave abnormalities were seen in patients over the age of 79. 9. 9. The high incidence of foci in this series could not alone be correlated with psychological test evidence of deterioration. When foci were associated with diffuse abnormalities, however, organic deterioration was definitely noted. Primarily left temporal foci were often clinically silent. The suggestion was made that hippocampal degenerations or beginning generalized vascular disease might be the cause. 10. 10. It was suggested that temporal foci could be more easily elicited using the vertex as a reference electrode, as well as keeping the ears “untied” and ungrounded. Also important was the use of the low-lying anterior temporal lead.

Significance of focal electroencephalographic changes in the elderly.

One-third of the population more than 60 years old will have an abnormal electroencephalogram of a focal type, consisting primarily of slow waves. This abnormality is usually maximal over the anterior temporal area and occurs more often on the left side of the brain. It is probably of vascular origin, although no consistent correlation has been established with physical or psychologic impairment. Its predilection for the left hemisphere is not related to cerebral dominance. The likelihood of seizures is not increased. The clinician is cautioned to avoid interpreting this finding as evidence of an expanding intracranial lesion.

How mind, body, and environment influence nutrition in the elderly.

Eating habits, food preferences, and attitudes affecting nutrition in the elderly are the result of the interaction of numerous interpersonal and intrapersonal forces. The physiologic changes that accompany aging must be understood by the clinician and accepted by the elderly person. Social stress and other environmental factors can adversely affect nutritional status.

ALTERATIONS IN NEUROLOGIC STATUS WITH AGE

Recent research in gerontology has included refined measurements of physiologic variables reflecting changes in the central nervous system in aging. Most such measurements are accurate and of general interest; however, they are of relatively little use to the clinician in his evaluation of the aged patient, because of the elaborate equipment required. Standard reference works in medicine offer little help to the physician who attempts to evaluate the neurologic status of his aged patient. Information to be presented in this paper is based on data gathered from routine neurologic examination which has not involved the use of complicated electrical or mechanical equipment.

Hypochondriasis in the Elderly: A Reaction to Social Stress*

ABSTRACT: Hypochondriasis in the elderly is often a preventable or reversible syndrome. It can become chronic if the patient finds no relief from social stress or becomes dependent upon medical services as a source of support. When this is recognized, psychotherapeutic intervention is necessary. Although no socioeconomic group is exempt, hypochondriasis in the elderly occurs more often among the lower social classes. Its higher prevalence in this group is attributable to the frequency and severity of social stress and the loss of alternative social opportunities. If psychotherapeutic intervention is necessary, the elderly hypochondriac patient should be helped to recognize social stress as a major source of the problem and to develop a realistic method of coping with it. Apparently the precipitating factors are often in the socioeconomic sphere; hence, social planners should be aware of this fact if the demands on the health care system are to be reduced.

PHYSICAL PROBLEMS OF OLDER PEOPLE

There are many indications from statistical studies that there is an increase in the frequency and severity of chronic illnesses among the older people in our society. In Leavell and Clark’s textbook of preventive medicine (1) it is indicated that host factors associated with aging result in a greatly increased prevalence rate of long-term illnesses involving circulatory impairments, metabolic dysfunctions, arthritides, and neoplasms. In referring to the National Health Survey published in 1940, it is stated that regarding chronic disease or impairment lasting three or more months, half of such cases occurred in persons over 45 years of age, consisting of less than one-third of the population. There were indications that the proportion increased with advancing age. This particular study showed that disability amounting to invalidism affected only 10.8 per thousand persons aged 30 to 44 years, 55 per thousand aged 65 to 74 years and 101 per thousand aged 85 years and over. Some of the major causes of disability and death from long-term illnesses become accentuated in the older age groups, according to Leavell and Clark ( 1 ) . The 10 leading causes of disability in persons aged 65 and over (Baltimore Survey) were: heart disease (excluding rheumatic), arthritis, hypertensive vascular disease, nephritis, tuberculosis, diseases of bones and joints (except tuberculosis and arthritis), accidents, diabetes, cancer, and eye diseases. These data came from a five-year survey with monthly visits (1). The 5 leading causes of death in 1956 in persons aged 65 years and over indicate that many of the leading causes of disability also cause most of the deaths in this age group. Taken from Public Health Service statistics ( 2 ) these were: diseases of the heart, cerebral hemorrhage and other vascular lesions effecting central nervous system, cancer and other malignant neoplasms, general arteriosclerosis, and all accidents.

Aging and Mental Disorders: International Perspectives

What do you do to start reading aging and mental disorders international perspectives? Searching the book that you love to read first or find an interesting book that will make you want to read? Everybody has difference with their reason of reading a book. Actuary, reading habit must be from earlier. Many people may be love to read, but not a book. Its not fault. Someone will be bored to open the thick book with small words to read. In more, this is the real condition. So do happen probably with this aging and mental disorders international perspectives.

Review of Proceedings: Directions for Future Research

In reviewing the proceedings of this meeting, I would prefer not to touch upon the individual papers but rather to confine my remarks to two separate areas of concern and interest. First, I would like to mention the things I believe were scientifically exciting. Second, I will want to touch upon aspects of the aging brain that I felt were omitted from this excellent program.

PHYSICAL PROBLEMS OF PSYCHIATRICALLY HOSPITALIZED ELDERLY PERSONS

A previous study in this series concerned the physical problems of 260 community volunteers past the age of 6O---a group which included persons from upper and lower socio-economic levels and both white and Negro races. Limitations on physical functional capacity were found to be related inversely to socioeconomic conditions and directly to increasing age. There were no differences between the patterns of illness in the various elderly age groups or in the two socio-economic groups (1). During the collection of data from the community group and from a group of 78 elderly persons hospitalized for psychiatric illness, a strong clinical impression was gained that persons hospitalized for psychiatric illness exhibit more physical illness than do community subjects. This report is concerned primarily with a description of the physical problems of psychiatrically hospitalized persons past the age of 60 and a comparison of their problems with those of community subjects.

Neuropeptides and Chemical Messengers in the Aging Brain

This presentation is a review of the rapidly expanding scientific knowledge regarding chemical messengers in the aging brain. There are two major classes of chemical messengers—neurotransmitters and neuropeptides. This paper focuses upon the peptide hormones — brain and peripheral. In the past the two classes of chemical messengers were assumed to be associated with either the nervous system or the endocrine system and were believed to have distinctly different modes of communication. Now it appears there is a degree of overlap, a sharing of selected communication methods and a combining of the activities of the two systems to affect the functioning of groups of cells.