Cognitive impairment in Parkinson's disease without dementia

Some degree of cognitive impairment appears frequently in Parkinson's disease (PD) patients, even at the onset of the disease. However, due to the heterogeneity of the patients and the lack of standardized assessment batteries, it remains unclear which capacities are primarily affected by this disease. Fifty PD patients were assessed with 15 tests including executive functions, attention, temporal and spatial orientation, memory, and language tasks. Their results were compared with those of 42 age‐ and education‐matched healthy seniors. Semantic fluency, along with visual search appeared to be the most discriminant tasks, followed by temporal orientation and face naming, as well as action naming and immediate recall. PD patients studied showed an impairment of frontal‐ to posterior‐dependent capacities. Executive functions, attention, and recall tasks appeared to be significantly impaired in the patients. Nevertheless, significantly poor scores in tasks like action and face naming, as well as semantic fluency, also reveal a mainly semantic deficit. © 2010 Movement Disorder Society     

Maternal-Infant Attachment: a Developmental Perspective

The formation of a close and satisfying maternal-infant bond is recognized as being an important contribution to the optimal psychosocial development of the child. However the relationship that develops between mother and infant is increasingly seen as an ongoing developmental process rather than a postpartum event, occurring in the first few days after birth. It is also being increasingly recognized that there are a multitude of factors during this period which affect the development of this relationship (14, 15, 16, 17). The father too plays an important role at this time, and his reactions to the birth as well as the support he is able to offer his wife are determinants in the evolving maternal-infant relationship. The view of bonding as an ongoing developmental process influenced by both ante- and postnatal factors, indicates some flexibility of response on the part of the mother when things do not go according to plan. For example, separation of mother and infant in the case of a premature delivery need not have an adverse effect on the development of the maternal-infant relationship provided that there is adequate support for the parents. Well trained I.C.U. staff and hospital practices that are sensitive to the needs of the parents at this time are important determinants here. It is felt that the success of the video programme, and the results of the long-term follow-up programme conducted at the Queen Victoria Hospital support this developmental view.     

The Lille Apathy Rating Scale: Validation of a caregiver‐based version

Apathy is reported in 16.5% to 70% of Parkinson's disease (PD) patients. Our recently developed Lille Apathy Rating Scale (LARS) has been specifically validated for patient‐based assessment of apathy in PD. The aim of the present study was to validate a caregiver‐based version of the LARS. Sixty consecutive PD patients and their respective caregivers participated in the study. An informant‐based version of the LARS (LARS‐i) was developed to rate apathy via a caregiver‐based structured interview. Apathy was also assessed in a patient‐based interview using the LARS and the informant‐ and clinician‐rated versions of the Apathy Evaluation Scale (AES). Cronbach's alpha and standardized alpha coefficients were 0.872 and 0.877, respectively, and the split‐half reliability was 0.901 (revealing good internal consistency). The test‐retest and inter‐rater reliability values were 0.960 and 0.996, respectively. Criterion‐related validity (according to an independent, expert diagnosis) was good. Scores on the LARS and the LARS‐i were highly correlated. However, apathy was rated significantly more severely by the caregiver than by the patient. This difference was significantly higher for demented than nondemented PD patients. The LARS‐i was seen to have excellent psychometric properties and appears to be valid for use in PD with respect to the patient‐based LARS and the informant‐ and clinician‐rated versions of the AES. © 2008 Movement Disorder Society     

Personal and Social Factors Influencing Age at First Sexual Intercourse

Early initiation of sexual activity is aconcern, in part because of increased risk of sexuallytransmitted diseases, including HIV, and unwantedpregnancies among young people. In this study, 241 high schoolers were administered a questionnaire toestablish the relationships between age at first sexualintercourse and personal qualities (sexual style,attractiveness, physical maturity, restraint, autonomy expectations, and attitudes to gender roles),smoking and drug use, and aspects of the social context(social activities, media impact, peer norms). Therewere few effects of sex of respondent and none in which respondents' sex impacted on age ofinitiation. Overall (and among the male sample),perceptions of greater physical maturity, greater use ofuncommon (mostly illicit) drugs, and expectations of earlier autonomy significantly differentiatedbetween early and later initiators. This group offactors tends to confirm the view that early experienceof sexual intercourse is correlated with problembehaviors and a press toward adultbehaviors. For girls, this pattern was even clearer,with use of uncommon drugs being replaced as asignificant contributor to early sexual experience byrelative lack of restraint. We conclude that the desire to achieve thetransition to adulthood at an earlier age than theirpeers constitutes a powerful incentive for young peopleto become sexually active.