The effect of design of residential homes in creating dependency among confused elderly residents: A study of elderly demented residents and their ability to find their way around homes for the elderly

A study of 13 homes for elderly people examining the effect of the environment on demented residents looked into the complexity of the design from the residents' point of view. Two principal tools were used in this investigation: ‘route diagrams’, which describe a resident's use of the home, and a measure devised to indicate each resident's ability to find her way around the home. These are described and the relationship between them explored. From this the following tentative conclusions are drawn:

• (i) The variables that influence a resident's ability to find her way around differ between group and communally designed homes.
• (ii) It would appear that group homes provide a more favourable design, especially in the case of physically frail demented elderly people.
• (iii) In group homes, the level of lighting is an important aid to a demented person in finding her way around.
• (iv) In communal homes, residents seem most able to find their way around homes that have been adapted from older premises.
• (v) In both types of home, ‘meaningful decision points’ can be seen as aids to a resident finding her way around.

     

社区老年期痴呆患者的随访研究

痴呆是一类高死亡率疾病 ,和心脏病、癌症及中风一起已成为威胁老年健康和生命的主要因素。本研究随访调查原有社区老年期痴呆患者 12 9例十年后的生存状况 ,现将资料报告如下。1　对象和方法1.1　对象1991年长沙市社区流调发现的 12 9例老年期痴呆患者[1] ,其中AD 116例 ,VD 13例。1.2　方法自编调查表 ,包括人口学资料 ,躯体疾病情况等。采用简易智力状态检查 (MMSE)、日常生活能力量表 (ADL)及功能活动调查表 (POD) [2 ] 对存活者进行功能评定。对于死者进一步了解死亡原因。2　结　　果2 .1　AD组和VD组生存时间频度分布病程≤ …     

米氮平与氟西丁治疗老年抑郁症患者的对照研究

目的探讨米氮平治疗老年抑郁症患者的疗效和副反应。方法46例符合CCMD-3抑郁症诊断标准的年龄〉60岁老年抑郁症患者，应用米氮平和氟西丁各23例进行随机对照研究，观察6周，采用汉密顿抑郁量表（HAMD）和副反应量表（TESS）观察患者对治疗的疗效和副反应的变化。结果两种药物疗效相仿，米氮平起效快，副反应少。结论米氮平治疗老年抑郁症患者安全有效，副反应小。     

帕罗西汀合用心理行为干预治疗老年期抑郁症的疗效

目的探讨帕罗西汀合用心理行为治疗对老年期抑郁症的疗效。方法将60例老年期抑郁症随机分成两组，进行为期6周的对照研究，出院后随访1年，分别用心理行为合并帕罗汀治疗（研究组）和帕罗西汀治疗（对照组）；采用汉密尔顿抑郁量表（HAMD）和临床疗效总评量表（CGI—SI）进行评定。结果研究组在治疗6周后HAMD评分（9．32±2．28）较对照组（13.17±3．39）有显著性差异（P〈0．01），研究组CGI—SI较对照组有显著性差异（P〈0．01），1年末随访时HAMD评分研究组（9.19±2．33）较对照组（13．98±4．96）有显著性差异（P〈0.01）。且研究组复发率低于对照组（P〈0.05）。结论帕罗西汀合用心理行为治疗对老年期抑郁症的疗效优于帕罗西汀，且复发率低。     

归因训练对老年性抑郁症康复的疗效观察

目的探讨归因训练对老年性抑郁症的增效作用。方法将老年抑郁症患者58例，随机分为归因训练合并西酞普兰组（研究组）和单纯西酞普兰组（对照组），进行对照研究，采用汉密顿抑郁量表（HAMD）和临床疗效总评量表（CGISI）于治疗前及治疗后6周末、半年末，进行评分比较。结果治疗6周末研究组同对照组评分比较有显著性差异（P〈0．01）。治疗半年末，研究组和治疗6周末同组比较有显著性差异（P〈0．01），而对照组无显著性差异（P〉0．05）。两组半年未复发率比较有显著性差异（X^2=6．44，P〈0．05）。结论归因训练能提高老年性抑郁症的近期和远期疗效，降低复发率。     

Neu-Laxova syndrome: Prenatal ultrasonographic diagnosis,clinical and pathological studies,and new manifestations

A diagnosis of the Neu-Laxova syndrome (NLS) was made by ultrasonography at 32 wks of gestation. Ultrasonographic examination showed intrauterine growth retardation (IUGR), Dandy-Walker anomaly, choroid plexus cysts, receding forehead and microcephaly, bilateral cataract without prominent eyes, scalp edema with no generalized edema, retrognathia, curved penis, and flexion deformities of limbs. The findings in this case are consistent with NLS; however, they did not fit any of Curry's [1982] groups. Massive swelling of hands and feet were among the main manifestations in classic NLS cases. In the case presented herein, edema was noted only in the scalp. This might shed further light on the question of variability vs. heterogeneity in the NLS. This case shows the existing possibility of an early diagnosis of NLS and adds Dandy-Walker anomaly and choroid plexus cysts as new findings to this syndrome. © 1992 Wiley-Liss, Inc.     

Aβ40 is a major form of β-amyloid in nonhuman primates

Because aged nonhuman primates show β-amyloid (Aβ) deposition in senile plaques and blood vessels similar to that seen in human aging and AD, we used C-terminal specific antibodies to Aβ₄₀ and Aβ₄₂ to investigate Aβ peptide length in the brains of 11 aged rhesus monkeys and a 59-year-old chimpanzee. In contrast to AD, where the earliest and most prominent form of Aβ in senile plaques is Aβ₄₂, in the monkey, Aβ₄₀-positive plaques predominated. The ratio of Aβ₄₎: Aβ₄₂-positive plaques averaged 2.08 in the monkey, as compared to a mean ratio of 0.37 in 68 human AD subjects (p < 0.001). Aβ₄₀ was also more prominent in the chimpanzee than in humans. Possible explanations for these findings include species differences in the cleavage of Aβ from the amyloid precursor protein or in the activity of a putative carboxy peptidase forming Aβ₄₀ from Aβ₄₂ in situ.     

杜仲对D-半乳糖所致衰老小鼠睾丸的形态学研究

目的 本实验以D－半乳糖所致衰老小鼠为研究对象，研究了杜仲的抗衰老作用。方法 应用光镜电镜技术观察小鼠睾丸的重量、生精小管直径、生精上皮细胞数、间质细胞数的随龄变化，同时观察了杜仲对上述指标的影响。结果 1、随增龄，睾丸重量减轻，生精小管直径缩小。衰老时生精细胞缺如，仅剩支持细胞或见散在分布，间质细胞随龄递减。2、杜仲具有一定的抗衰老作用，使生精过程活跃，生精细胞增多，间质细胞增多不明显，生精小管直径改变不显著。结论 杜仲具有一定的抗衰老作用。     

Abnormal distribution of cathepsins in the brain of patients with Alzheimer's disease

Formalin-fixed paraffin-embedded hippocampal sections of brains with early-onset and late-onset Alzheimer's disease were studied immunohistochemically with antisera against cathepsin D and cathepsin B. In addition to the staining of neuronal perikarya, some of the senile plaques visualized by Bielshowsky silver staining and some of reactive astrocytes were positively stained with the antisera against cathepsin D and cathepsin B in brains with Alzheimer's disease. Abnormal localization of cathepsin D and cathepsin B immunoreactivity in neuronal perikarya was observed in brains with early-onset Alzheimer's disease. These findings demonstrate that the distribution of lysosomal proteases was altered in brains with Alzheimer's disease, suggesting the primary and/or secondary involvement of the lysosomal proteases in the pathological process of Alzheimer's disease.     

中国东北汉族一个先天性白内障家系致病基因的鉴定

目的鉴定一个先天性白内障家系的致病基因。方法根据已知与先天性白内障有关的12个致病基因的染色体上的定位,分别选取3～4个的微卫星标记位点,对该家系进行连锁分析。通过测序鉴定致病基因。结果在1q21.1GJA8位点显示最大Lod值2.44。致病基因定位于1q21.1区的GJA8基因,构成缝隙连接的缝隙连接蛋白Connexin50。DNA序列分析鉴定显示其第2外显子的第191个碱基杂合突变T>G导致其蛋白产物第64位缬氨酸转变为甘氨酸。结论Connexin50的V64G新生突变是导致该家系的致病原因。