Marian B. Patterson

Assessment of behavioral and affective symptoms in Alzheimer's disease

Noncognitive behavioral symptoms occurring during the prior week were studied in 34 Alzheimers disease (AD) patients and 21 spousal control subjects via caregiver and patient interviews using the Behavioral Pathology in Alzheimers Disease Rating Scale and the Cornell Scale for Depression in Dementia. Delusional or paranoid features were reported in 13 subjects (38%) and hallucinations in six (18%); patients with these psychoticlike symptoms had lower scores on the Folsteins Mini-Mental State Examination. Other behavioral symptoms reported in AD patients included anxiety (50%) and activity disturbances (44%). Six AD subjects (18%) and two controls (10%) showed mild to moderate symptoms of depression ; AD subjects were more likely than controls to show behavioral signs and symptoms of depression, but the two groups did not differ in terms of mood-related, cyclical, or physical signs and symptoms. (J Geriatr Psychiatry Neurol 1990;3:21-30).

Validation of a telephone cognitive assessment battery

OBJECTIVE: To present and evaluate an instrument, the Telephone Cognitive Assessment Battery (TCAB), designed to be administered over the telephone to assess the cognitive status of older individuals. The TCAB addresses mental status, reasoning and executive ability, primary and secondary memory, and language. It consists of six neuropsychological tests and takes approximately 15 to 20 minutes to complete.

The evaluation of behavioral disturbances in Alzheimer's disease: the utility of three rating scales.

Behavioral disturbances, eg, wandering, irritability, depression, and delusions, are observed in Alzheimers disease (AD). Determining the importance of such symptoms requires that they be evaluated objectively. The Behavioral Pathology in Alzheimers Disease Rating Scale (Behave-AD), Cornell Scale for Depression in Dementia (Cornell), and Brief Psychiatric Rating Scale (BPRS) were administered to 61 AD and 20 elderly control subjects. Only one AD subject showed no behavioral symptoms. All scales were reliably rated for presence or absence of symptoms. However, assessment of reliability of severity ratings was limited, because symptom frequency and severity were low. Although the Cornell and Behave-AD appeared more appropriate for AD subjects than did the BPRS, neither scale provided a complete description of behavioral symptoms, and each showed problems that interfere with its use. We recommend the development of a comprehensive scale with a well-anchored system of scaling and detailed rater instructions.

Characterization of Depression in Alzheimer's Disease by the CERAD Behavior Rating Scale for Dementia (BRSD)

The authors selected 69 participants from an Alzheimers disease research registry and diagnosed them as depressed or nondepressed by use of a semi-structured clinical interview. Responses to selected BRSD items were compared between the depressed and nondepressed groups. Differences between responses of the two groups on BRSD items related to anxiety and depression were significant. The groups did not significantly differ in their responses to items related to other content areas. On the basis of their responses to the BRSD anxiety and depression items, 70% of participants were correctly classified as depressed or nondepressed.

The Cleveland Scale for Activities of Daily Living (CSADL): Its Reliability and Validity

This study evaluated the reliability and validity of the Cleveland Scale for Activities of Daily Living (CSADL), a scale designed to measure in detail specific activities of daily living in individuals with dementia. Administered to knowledgeable informants by trained examiners, the CSADL demonstrated good reliability in terms of interrater agreement and internal consistency. The validity of CSADL total scores was shown by its sensitivity to degree of cognitive impairment: All comparisons between means of the healthy elderly group and three groups of AD patients differing in severity were statistically significant. The CSADL was highly correlated with the Blessed–Roth Dementia Scale (DS-ADL) and more highly correlated with Mini-Mental State Exam scores than was the DS-ADL.

Continuing Education Needs in Clinical Geropsychology: The Practitioners' Perspective

Abstract Presently, older adults are under-served by psychologists. In part this reflects a lack of psychologists proficient in clinical geropsychology to provide appropriate treatment. The present study provides information gathered from practitioners for planning continuing education programs in clinical geropsychology. The findings describe the characteristics of clinicians pursuing additional training to work with older adults, and their topical preferences and training needs to guide future continuing education offerings. In addition, the practitioners opinions regarding a possible credential recognizing competence in clinical geropsychology are discussed.

An Empirical Basis for Domains in the Analysis of Dependency in the Activities of Daily Living (ADL): Results of a Confirmatory Factor Analysis of the Cleveland Scale for Activities of Daily Living (CSADL)

This study examines the empirical basis for dividing activities of daily living (ADLs) into broad behavioral domains. Following an exploratory factor analysis of results from the Cleveland Scale for Activities of Daily Living (CSADL), a two-factor model of ADLs was tested in a confirmatory factor analysis using two groups of demented patients. The model, which included a Basic and an Instrumental factor, was confirmed. Comparison of the item composition of the CSADL factors with a priori domains used by other ADL scales suggested that the results of the present study are broadly generalizable. The two factors are correlated, and cautions were raised concerning the likelihood that many ADL items may reflect both basic and instrumental domains.