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Diagnostic Problems in Geriatric Psychiatry

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Contemporary Psychiatry
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Abstract

There are three main areas of difficulty in the diagnosis of mental illness in elderly patients: (1) the differentiation of mental disorders from the mental changes of nonpathological aging, (2) the differentiation of mental disorders from the signs and symptoms of physical illness and impairment, and (3) the differentiation of mental illnesses from one another.

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References

  • Alsen V (1960) Euphoric Hüthig, Heidelberg

    Google Scholar 

  • Arnold SE, Trojanowski JQ, Gur RE, Blackwell P, Han LY, Choi C (1998) Absence of neurodegeneration and neural injury in the cerebral cortex in a sample of elderly patients with schizophrenia. Arch Gen Psychiatry 55: 225–232

    Article  PubMed  CAS  Google Scholar 

  • Baltes MM, Kühl KP, Sowarka D (1992) Testing for limits of cognitive reserve capacity: a promising strategy for early diagnosis of dementia? J Geront Psychol Sci 47: 165–167

    Google Scholar 

  • Baltes PB (1997) Die unvollendete Architektur der menschlichen Ontogenese: Implikationen für die Zukunft des vierten Lebensalters. Psychol Rundschau 48: 191–210

    Google Scholar 

  • Berg L, Coben LA, Smith DS, Morris JC, Miller JP, Rubin EH, Storandt M (1990) Mild senile dementia of the Alzheimer type. 3. Longitudinal and cross-sectional assessment. Ann Neurol 28: 648–652

    Article  PubMed  CAS  Google Scholar 

  • Berkman LF, Berkman CS, Kasl S, Freeman DH, Leo L, Ostfeld AM, Cornony-Huntley J, Brody JA (1986) Depressive symptoms in relation to physical health and function in the elderly. Am J Epidemiol 124: 372–388

    PubMed  CAS  Google Scholar 

  • Borchelt M, Geiselmann B (1995) Are there specific health characteristics in depression versus dementia in old age? In: Bergener M, Brocklehurst JC, Finkel S (eds) Aging, health and healing. Springer, Berlin Heidelberg New York, pp 427–440

    Google Scholar 

  • Borchelt M, Gilberg R, Horgass AL, Geiselmann B (1996) Zur Bedeutung von Krankheit und Behinderung im Alter. In: Mayer KU, Baltes PB (eds) Die Berliner Altersstudie. Akademieverlag, Berlin, pp 449–474

    Google Scholar 

  • Brayne C, Gill C, Paykel ES, Huppert F, O’Connor DW (1995) Cognitive decline in an elderly population — a two wave study of change. Psychol Med 25: 673–683

    Article  PubMed  CAS  Google Scholar 

  • Bulbena A, Berrios GE (1986) Pseudodementia: facts and figures. Brit J Psychiatry 148: 87–94

    Article  CAS  Google Scholar 

  • Butler RN (1990) A disease called ageism. J Am Geriatr Soc 38: 178–190

    PubMed  CAS  Google Scholar 

  • Christensen H, Griffiths K, Mackinnon A, Jacomb P (1997) A quantitative review of cognitive deficits in depression and Alzheimer-type dementia. J Int Neuropsychol Soc 3: 631–651

    PubMed  CAS  Google Scholar 

  • Ciompi L, Müller C (1976) Lebensweg und Alter der Schizophrenen. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Cooper SA (1997a) High prevalence of dementia among people with learning disabilities not attributable to Down’s syndrome. Psychol Med 27: 609–616

    Article  PubMed  CAS  Google Scholar 

  • Cooper SA (1997b) Psychiatric symptoms of dementia among elderly people with learning disabilities. Int J Geriatr Psychiatry 12: 662–666

    Article  PubMed  CAS  Google Scholar 

  • Davidson M, Harvey PD, Powchik P, Parella M, White I, Knobler HY, Losonczy MF, Keefe RSE, Katz S, Frecska E (1995) Severity of symptoms in chronically institutionalized geriatric schizophrenic patients. Am J Psychiatry 152: 197–207

    PubMed  CAS  Google Scholar 

  • *Devanand DP, Sano M, Tang MX, Taylor S, Gurland, BJ, Wilder D, Stern Y, Mayeux R (1996) Depressed mood and the incidence of Alzheimer’s disease in the elderly living in the community. Arch Gen Psychiatry 53: 175–182

    Article  PubMed  CAS  Google Scholar 

  • Duggan L, Lewis M, Morgan J (1996) Behavioural changes in people with learning disability and dementia: a descriptive study. L Intellect Disabil Res 40: 311–321

    Google Scholar 

  • *Emery VO, Oxman TE (1992) Update on the dementia spectrum of depression. Am J Psychiatry 149: 305–317

    PubMed  CAS  Google Scholar 

  • Ernst C, Angst J (1995) Depression in old age. Is there a real decrease in prevalence? Eur Arch Psychiatr Clin Neurosci 245: 272–287

    Article  CAS  Google Scholar 

  • Folstein M, McHugh P (1978) Dementia syndrome of depression. In: Katzman R, Terry RD, Bick KL (eds) Alzheimer’s disease: senile dementia and related disorders; aging. Raven, New York

    Google Scholar 

  • Fratiglioni L, Grut M, Forsell Y, Grafström M, Holmén K, Eriksson K, Viitanen M, Bäckman L, Ahlbom A, Winblad B (1991) Prevalence of Alzheimer’s disease and other dementias in an elderly urban population: relationship with age, sex and education. Neurology 41: 1886–1892

    Article  PubMed  CAS  Google Scholar 

  • Geiselmann B, Bauer M (2000) Subthreshold depression in the elderly: qualitative or quantiative distinction? Compr Psychiatry 41 [Suppl 1]: 32–38

    Article  PubMed  CAS  Google Scholar 

  • Hafner H (1997) Was tun mit Krankheiten, die keine sind? Subdiagnostische Störungen und unversorgte Morbidität. Münch Med Wochenschr 139: 158–160

    Google Scholar 

  • Harvey PD, White L, Parella M, Putnam KM, Kincaid MM, Powchik P, Mohs RC, Davidson M (1995) The longitudinal stability of cognitive impairment in schizophrenia. Minimental state scores at one- and two-year follow-ups in geriatric in-patients. Br J Psychiatry 166: 630–633

    Article  PubMed  CAS  Google Scholar 

  • Helmchen H, Linden M (1993) The differentiation between depression and dementia in the very old. Ageing Soc 13: 589–617

    Article  Google Scholar 

  • Helmchen H, Linden M (2000) Subthreshold disorders in psychiatry: clinical reality, methodological artifact, and the double-threshold problem. Compr Psychiatry 41[Supp 1]: 1–7

    Article  PubMed  CAS  Google Scholar 

  • Helmchen H, Reischies FM (1998) Normales und pathologisches kognitives Altern. Nervenarzt 69: 369–378

    Article  PubMed  CAS  Google Scholar 

  • Heimchen H, Baltes MM, Geiselmann B, Kanowski S, Linden M, Reischies FM, Wagner M, Wernicke T, Wilms HU (1999) Psychiatric illnesses in old age. In: Baltes PB, Mayer KU (eds) The Berlin Aging Study. Aging from 70 to 100. Cambridge University Press, New York, pp 167–196

    Google Scholar 

  • Henderson SA (1990) Co-occurrence of affective and cognitive symptoms: the epidemiological evidence. Dementia 1: 119–123

    Google Scholar 

  • Illhardt FJ (1993) “Ageism”: Vorurteile gegen das Alter. Z Gerontol 26: 335–338

    PubMed  CAS  Google Scholar 

  • Israel L, Kozarevic D, Sartorius N (1984) Source book of geriatric assessment, vols I and IL Karger, Basel

    Google Scholar 

  • Jacob H (1986) Krankheitserleben und Altersstörungen. Akt Neurol 13: 28–34

    Article  Google Scholar 

  • Johannsen P, Christensen JE, Mai J (1996) The prevalence of dementia in Down syndrome. Dementia 7: 221–225

    PubMed  CAS  Google Scholar 

  • Kage A, Nitschke I, Fimmel S, Köttgen E (1996) Referenzwerte im Alter: Beeinflussung durch Alter, Medikation und Morbidität. In: Mayer KU, Baltes PB (eds) Die Berliner Altersstudie. Akademieverlag, Berlin, pp 405–428

    Google Scholar 

  • Kay DWK, Beamish P, Roth M (1964) Old age mental disorders in Newcastle-upon-Tyne. IL A study of possible social and medical causes. Br J Psychiatry 110: 668–682

    Article  PubMed  CAS  Google Scholar 

  • Kiloh LG (1961) Pseudodementia. Acta Psychiatr Scand 37: 336–351

    Article  PubMed  CAS  Google Scholar 

  • Knäuper B, Wittchen HU (1994) Diagnosing major depression in the elderly: evidence for response bias in standardized diagnostic interviews? J Psychiatr Res 28: 147–164

    Article  PubMed  Google Scholar 

  • Kral VA (1983) The relationship between senile dementia (Alzheimer type) and depression. Can J Psychiatry 28: 304–306

    PubMed  CAS  Google Scholar 

  • *Kral VA, Emery OB (1989) Long-term follow-up of depressive pseudodementia of the aged. Can J Psychiatry 34: 445–446

    PubMed  CAS  Google Scholar 

  • Lauter H, Dame S (1991) Depressive disorders and dementia: the clinical view. Acta Psychiatr Scand Suppl 366: 40–46

    Article  PubMed  CAS  Google Scholar 

  • Lehr U, Thomae H (eds) (1987) Formen seelischen Alterns: Ergebnisse der Bonner Gerontologischen Längsschnittstudie (BOLSA). Enke, Stuttgart

    Google Scholar 

  • Linden M, Barnow S (1998) The wish to die in very old persons near the end of life: a psychiatric problem? Results from the Berlin Aging Study. Int Psychogeriatr 9: 291–307

    Article  Google Scholar 

  • Linden M, Borchelt M, Barnow S, Geiselmann B (1995) The impact of somatic morbidity on the Hamilton Depression Rating Scale in the very old. Acta Psychiatr Scand 92: 150–154

    Article  PubMed  CAS  Google Scholar 

  • Linden M, Gilberg R, Horgas AL, Steinhagen-Thiessen (1996a) Die Inanspruchnahme medizinischer und pflegerischer Hilfe im hohen Alter. In: Mayer KU, Baltes PB (eds) Die Berliner Altersstudie. Akademieverlag, Berlin, pp 475–496

    Google Scholar 

  • Linden M, Maier W, Achberger M, Herr R, Helmchen H, Benkert O (1996b) Psychische Erkrankungen und ihre Behandlung in Allgemeinarztpraxen in Deutschland. Ergebnisse aus einer Studie der Weltgesundheitsorganisation (WHO). Nervenarzt 67: 205–215

    PubMed  CAS  Google Scholar 

  • Linden M, Kurtz G, Baltes MM, Geiselmann B, Lang F, Reischies FM, Helmchen H (1998) Depression bei Hochbetagten. Ergebnisse der Berliner Altersstudie. Nervenarzt 69: 27–37

    Article  PubMed  CAS  Google Scholar 

  • Lindenberger U, Mayr U, Kliegl R (1993) Speed and intelligence in old age. Psychol Aging 8: 207–220

    Article  PubMed  CAS  Google Scholar 

  • Lishman WA (1987) Organic psychiatry. The psychological consequences of cerebral disorders, 2nd edn. Blackwell, Oxford

    Google Scholar 

  • Liston EH (1977) Occult presenile dementia. J Nerv Ment Dis 164: 263–267

    Article  PubMed  CAS  Google Scholar 

  • Lobo A, Campos R (1997) Managing the psychiatry/primary care interface. In: Robertson MM, Katona CLE (eds) Depression and physical illness. Wiley, Chichester, pp 39–66

    Google Scholar 

  • Madden JJ, Lohan JA, Kaplan LA, Manfredi HM (1952) Nondementing psychoses in older persons. JAMA 150: 1567–1570

    Article  CAS  Google Scholar 

  • Maier W, Herr R, Lichtermann D, Gansicke M, Benkert O, Faust G (1994) Brief depression among patients in general practice. Prevalence and variation by recurrence and severity. Eur Arch Psychiatry Clin Neurosci 244: 190–195

    Article  PubMed  CAS  Google Scholar 

  • Moritz DJ, Petitti DB (1993) Association of education with reported age of onset and severity of Alzheimer’s disease at presentation: implications of the use of clinical samples. Am J Epidemiol 137: 456–462

    PubMed  CAS  Google Scholar 

  • Mortimer JA (1990) Epidemiology of dementia: cross-cultural comparisons. Adv Neurol 51: 27–33

    PubMed  CAS  Google Scholar 

  • Moss S, Patel P (1997) Dementia in older people with intellectual disability: symptoms of physical and mental illness, and levels of adaptive behaviour. J Intellect Disabil Res 41: 60–69

    Article  PubMed  Google Scholar 

  • O’Connor DW, Pollit PA, Treasure FP (1991) The influence of education and social class on the diagnosis of dementia in a community population. Psychol Med 21: 219–224

    Article  PubMed  Google Scholar 

  • Palmore EB (1988) The facts on aging quiz: a handbook of uses and results. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Parsons PL (1965) Mental health of Swansea’s old folk. Br J Prev Soc Med 19: 43–47

    PubMed  CAS  Google Scholar 

  • Post F (1962) The significance of affective symptoms in old age. Oxford University Press, London

    Google Scholar 

  • Prasher VP, Chung MC (1996) Causes of age-related decline in adaptive behavior of adults with Down syndrome: differential diagnosis of dementia. Am J Ment Retard 101: 175–183

    PubMed  CAS  Google Scholar 

  • Purohit DP, Perl DP, Haroutunian V, Powchik P, Davidson M, Davis KL (1998) Alzheimer disease and related neurodegenerative diseases in elderly patients with schizophrenia: a postmortem neuropathologic study of 100 cases. Arch Gen Psychiatry 55: 205–211

    Article  PubMed  CAS  Google Scholar 

  • Rabins PV, Pearlson GD (1994) Depression induced cognitive impairment. In: Burns A, Levy R (eds) Dementia. Chapman and Hall, London, pp 667–679

    Chapter  Google Scholar 

  • Rajkowska G, Selemon LD, Goldman-Rakic PS (1998) Neuronal and glial somal size in the prefrontal cortex: a postmortem morphometric study of schizophrenia and Huntington disease. Arch Gen Psychiatry 55: 215–224

    Article  PubMed  CAS  Google Scholar 

  • Reifler BV, Larson E, Hanley R (1982) Coexistence of cognitive impairment and depression in geriatric outpatients. Am J Psychiatry 139: 623–626

    PubMed  CAS  Google Scholar 

  • Reifler BV, Ter L, Raskind M, Veith R, Barnes R, White E, McLean P (1989) Double-blind trial of imipramine in Alzheimer’s disease patients with and without depression. Am J Psychiatry 146: 45–49

    PubMed  CAS  Google Scholar 

  • Reischies FM (1998) Age related cognitive decline and the dementia threshold. In: Lomranz J (ed) Handbook of aging and mental health. Plenum, New York, pp 435–448 (in press)

    Google Scholar 

  • Reischies FM, Geiselmann B (1997) Age-related cognitive decline and vision impairment affecting the detection of dementia syndrome in old age. Br J Psychiat 171: 449–451

    Article  CAS  Google Scholar 

  • Reischies FM, Lindenberger U (1996) Grenzen und Potentiale kognitiver Leistungen im hohen Alter. In: Mayer KU, Baltes PB (eds) Die Berliner Altersstudie. Akademieverlag, Berlin, pp 351–377

    Google Scholar 

  • Reischies FM, Schaub T (1997) Epidemiologische Verlaufsuntersuchungen der Demenz. In: Rosier M, Retz W, Thome J (eds) Proceedings des Aloys Alzheimer Symposiums Würzburg. Deutscher Studienverlag, Weinheim, pp 58–66

    Google Scholar 

  • Reischies FM, Geiselmann B, Geßner R, Kanowski S, Wagner M, Wernicke TM, Helmchen H (1997) Demenz bei Hochbetagten. Ergebnisse der Berliner Altersstudie. Nervenarzt 68: 719–729

    Article  PubMed  CAS  Google Scholar 

  • Roth M (1955) The natural history of mental disorder in old age. J Ment Sci 101: 281–301

    PubMed  CAS  Google Scholar 

  • Salthouse TA (1982) Adult cognition, an experimental psychology of human aging. Springer, Berlin Heidelberg New York

    Book  Google Scholar 

  • Salthouse TA (1985) A theory of cognitive aging. North Holland, Amsterdam

    Google Scholar 

  • Satzger W, Dragon E, Engel RR (1996) Zur Normenäquivalenz von HAWIE-R und HA WIE. Diagnostika 43: 119–138

    Google Scholar 

  • Schmand B, Lindeboom J, Launer L, Dinkgreve M, Hooijer C, Jonker C (1995) What is a significant score change on the mini-mental-state examination? Int J Geriatr Psychiatry 10: 411–414

    Article  Google Scholar 

  • Shraberg D (1978) The myth of pseudodementia: depression and the aging brain. Am J Psychiatry 135: 601–603

    PubMed  CAS  Google Scholar 

  • Staudinger U, Freund AM, Linden M, Maas I (1996) Selbst, Persönlichkeit und Lebensgestaltung im Alter: Psychologische Widerstandsfähigkeit und Vulnerabilität. In: Mayer KU, Baltes PB (eds) Die Berliner Altersstudie. Akademieverlag, Berlin, pp 321–350

    Google Scholar 

  • Steinhagen-Thiessen E, Borchelt M (1996) Morbidität, Medikation und Funktionalität im Alter. In: Mayer KU, Baltes PB (eds) Die Berliner Altersstudie. Akademieverlag, Berlin, pp 151–183

    Google Scholar 

  • Stevens DE, Merikangas KR, Merikangas JR (1995) Comorbidity of depression and other medical conditions. In: Beckham EE, Leber WR (eds) Handbook of depression. Guilford, New York, pp 147–199

    Google Scholar 

  • Thomae H, Maddox GL (eds) (1982) New perspectives on old age: a message to decision makers. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Weitingh MD, Bossuyt PMM, van Crewel H (1995) Reversible dementia: more than 10% or less than 1%? A quantitative review. J Neurol 242: 466–471

    Article  Google Scholar 

  • Wells CE (1979) Pseudodementia. Am J Psychiatry 136: 895–900

    PubMed  CAS  Google Scholar 

  • Zimmer R, Lauter H (1984) Zum Problem der depressiven Pseudodemenz. Z Gerontol 17: 109–112

    PubMed  CAS  Google Scholar 

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Helmchen, H., Lauter, H. (2001). Diagnostic Problems in Geriatric Psychiatry. In: Henn, F., Sartorius, N., Helmchen, H., Lauter, H. (eds) Contemporary Psychiatry. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59519-6_50

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