Mitsuo Nomaguchi

A STUDY OF THE QUALITY OF LIFE IN ELDERLY PEOPLE USING PSYCHOLOGICAL TESTING

To study factors which influence the quality of life (QOL) in the elderly, we investigated the relationship between scores on the modified Philadelphia Geriatric Center (JPGC) Morale Scale and various other psychological tests in 51 elderly people residing in a long‐term care facility. The JPGC Morale Scale score correlated with the scores for all sections of the Japanese version of the Cornell Medical Index (JCMI), but not with those for the Mini Mental State Examination, the Kohs block design test, the Bender Gestalt test and the activities of daily living (ADL). Both somatic and psychotic symptoms on the JCMI were correlated with the dementia behaviour disturbance scale score and walking ability according to the ADL. Subjects were further divided into four groups according to Fukamachis neurotic discriminative diagram based on the JCMI. Scores for most sections of somatic and psychotic symptoms on the JCMI were elevated in proportion to the degree of neurotic tendencies in the elderly. These results indicate that the QOL of the elderly is influenced by subjective symptoms, but not by the degree of cognitive impairment or the ADL.

Relationships between convulsive seizures and serum and brain concentrations of phenobarbital and zonisamide in mutant inbred strain EL mouse

We evaluated the anticonvulsive effects of phenobarbital (PB) and zonisamide (ZNS) in the EL mouse, a strain that is highly susceptible to seizures. The concentration of each agent was analyzed in the serum and brain. PB suppressed the seizures dose-dependently, whereas even the higher dose of ZNS was ineffective in achieving a complete suppression. Serum and brain concentrations of these two drugs increased in proportion to the higher dose injected intraperitoneally. Brain concentration of PB was lower than the serum concentration, while the brain concentration of ZNS exceeded that in serum. Although serum concentration of ZNS was essential unchanged after the combined administration of PB and ZNS, the concentration of ZNS in brain tended to rise in proportion to the highly dose of PB. Combined administration was more effective than other treatment alone. Results indicated that brain concentration of ZNS especially after concomitant PB administration, were higher than that would be expected from the concentration of ZNS in serum.

Blood flow velocity waveform in the common carotid artery and its analysis in elderly subjects

We investigated common carotid artery blood flow in 99 elderly nursing home residents using an ultrasonic quantitative blood flow measurement system. Systolic velocity and end-diastolic velocity were obtained from the waveform and classified, using the end-diastolic/systolic volume as Type A which is normal flow (>20% bilaterally), Type B which is unilateral decreased flow (<20% unilaterally), Type C which is bilateral decreased flow (<20% bilaterally), Type D which is Type C plus a saw tooth pattern and Type E which is no diastolic pattern, i.e. a value of 0 unilaterally or bilaterally. Five per cent of subjects showed Type A of blood flow velocity waveform (normal flow pattern) and about 40% showed Type E (no diastolic pattern). The subjects were divided into three groups according to blood flow velocity waveform. Groups 1, 2 and 3 showed Types A or B, C or D, and E, respectively. The total blood flow volume and mean blood flow velocity of Group 1 were significantly higher than those of Groups 2 and 3 in both the supine and sitting positions. Although both total blood flow volume and mean blood flow velocity of Group 1 decreased significantly in postural change, those of Groups 2 and 3 did not change. These results suggest that total blood flow volume and mean blood flow velocity decrease in proportion to changes in the blood flow velocity waveform.

Depression and Quality of Life in the Elderly in a Special Nursing Home

Abstract: Using a Japanese version of the Self‐Rating Depression Scale by Zung (SDS) and the Quality of Life (QOL) rating scale designed by Iida et al. (QOL scale), we compared the QOL and depressive state of special nursing home residents and the elderly in the general community. The QOL scale has four categories: physical functioning, emotional adjustment, interpersonal relationships and attitudes toward life. High scores in either examination indicate a greater impairment. The SDS scores of the residents in the special nursing home were significantly lower than those of the elderly in the community, but the scores in 3 categories and the total score, except for those of physical functioning of the QOL, were significantly higher in the nursing home residents. In the nondepressed elderly rated by the SDS, the physical functioning score of the elderly in the community significantly exceeded that of the special nursing home residents. In the depressed elderly, all the scores including the total score were significantly higher than those in the special nursing home residents. Our results suggest that while the QOL of the depressed elderly in a special nursing home was poorer than that of the elderly in the community, their depression could be treated. However, the QOL cannot be improved by treatment alone.

Sex Difference in Depression and Quality of Life in Elderly People

Abstract: Two hundred and two elderly people who have been visiting a Day Service Center were examined by a Japanese version of the self‐rating depression scale by Zung (SDS) and the quality of life rating scale to suit Japanese conditions (QOL scale). The QOL scale measures four aspects: physical functioning, emotional adjustment, interpersonal relationship and attitudes toward life. Significant correlations were seen between the scores of three aspects and the total score except for the score of interpersonal relationship. Although no significant difference was found between the sexes in scores of the SDS, all the scores of aspects and the total score of the QOL scale of the male subjects were significantly higher than those of the female subjects.

Developing of EEG Print and Its Preliminary Technical Application

In this report, we discuss a method called “EEG print” to represent EEG contrast mapping in time and frequency domains simultaneously. A bank of bandpass FIR (Finite Impulse Response) digital filters is used to obtain EEG prints. EEG prints were taken from four areas (F3, F4, O1 and O2) of EEG when healthy subjects were at rest with their eyes closed. The pattern of the prints was classified into four types: α type, β type, α+β type and complex type. It was found that EEG prints may vary from person‐to‐person but they usually do not vary much between the four areas for a given person. The method is further modified to obtain “differential EEG prints” to investigate whether meaningful higher frequency EEG components exist. Differentiation of EEG resulted in marked intensification of the fast waves, using 0.14 Hz as the critical point. In differential EEG print with higher order differentiation, amplification in the high frequency components increase their frequency. As a result, it is possible to observe variations in the high frequency components, which are otherwise not detectable in the usual EEG print. EEG print can be used for representing the function of the brain. Using the method for classification of EEG print patterns, described in this paper, we can clarify not only the characteristics of the normal brain but also the pathophysiology of mentally‐ill patients.

Water intoxication in a schizophrenic patient with rhabdomyolysis

Abstract: We report a case of water intoxication in a 54‐year‐old female schizophrenic patient with rhabdomyolysis. She had been admitted to a mental hospital, and treated with spiperone 6 mg daily. On August 3, 1992, the coma following a convulsion occurred. Laboratory data initially showed marked hyponatremia and hypochloremia with decreased serum potassium, and a gradual increase in serum creatine phosphokinase (CPK). The elevation in serum CPK with marked hyponatremia observed in the present patient was probably caused by excessive drinking of water. In this patient, the CPK elevation revealed the rhabdomyolysis.

Influences of prolonged bed rest and cognitive impairment on nursing home residents.

Abstract: Seventy nursing home residents with and 87 without cerebrovascular diseases (CVD) were examined by the modified Stockton Geriatric Rating Scale (modified SGRS) which measures four aspects of impairments; physical disability, socially irritating behavior, communication failure and apathy. They were divided into 3 subgroups according to walking ability; prolonged bed rest, walking with aids and walking by themselves in both groups. Physical disability of mental decline was significantly aggravated more than that of normal intelligence in all the subgroups. Although communication failure and apathy of mental decline had deteriorated more than those of normal intelligence in prolonged bed rest in residents without CVD, apathy of the former had deteriorated more than that of the latter in walking by themselves in residents with CVD.

Accelerated Plethysmogram in Nursing Home Residents

Abstract: To investigate the peripheral blood circulation, 24 young volunteers, 28 nursing home residents with cerebrovascular diseases (CVD) and 42 residents without them were studied for accelerated plethysmogram (APG). Both residents were rated by the modified Stockton geriatric rating scale (modified SGRS) which have four aspects of impairments; physical disability, socially irritating behavior, communication failure and apathy. As to the waveform patterns of APG, the majority of the young volunteers and both the residents showed patterns B and G, respectively. Coefficient of APG (Co‐APG) of the former was significantly larger than that of the latter. In the residents without CVD, Co‐APG was significantly negatively correlated with physical disability and apathy of the modified SGRS. But, Co‐APG did not correlate with the modified SGRS in the residents with CVD.

Three‐Year Follow‐Up Studies on Heart Rate Variability in Nursing Home Residents

Abstract: The coefficient of variation of the R‐R interval (CV value) of nursing home residents was investigated twice during a three‐year period. The initial CV value of the deceased during the period was significantly lower than that of the survivors. Among the survivors, residents without chronic cerebrovascular disease mainly showed a decrease in their CV values during the period.