RESUMO
This study, based on evaluations of 240 outpatients with Alzheimer's disease or multi-infarct dementia, examines whether race has any independent effects on the prevalence and levels of related neuropsychiatric symptoms. After the authors controlled for 14 potentially confounding variables, race had a significant independent effect on the levels of psychotic and depressive symptoms, the former being greater among blacks and the latter among whites. There were no differences in symptoms between U.S.-born African Americans and African Caribbeans. Although it is likely that racial differences reflect variations in symptoms brought in for evaluation, the absence of intraracial differences suggests the possibility of an underlying biological process.
Assuntos
Doença de Alzheimer/etnologia , População Negra , Demência por Múltiplos Infartos/etnologia , Transtorno Depressivo/etnologia , Transtornos Psicóticos/etnologia , População Branca , Negro ou Afro-Americano/psicologia , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Comorbidade , Fatores de Confusão Epidemiológicos , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Estados Unidos , Índias Ocidentais/etnologia , População Branca/psicologiaRESUMO
OBJECTIVES: To review the management of a cohort of patients with positive treponemal serology and psychiatric and/or neurological disorders. METHODS: A retrospective case note review of 172 patients with positive treponemal serology attending the Patrick Clement's Clinic, Central Middlesex Hospital between December 1990 and November 1995 was performed. RESULTS: 101 men and 71 women were new attenders diagnosed with positive treponemal serology. A neurological problem was identified in 27 patients (12 women and 15 men) with psychiatric and/or neurological disorders, of whom 20 (six women and 14 men) underwent investigation of the cerebrospinal fluid (CSF). With the medical history and results of CSF-RPR and FTA tests, white cell count (WCC), and total protein level in the CSF, 10 patients (eight men and two women) were diagnosed with likely neurosyphilis and 17 with neurological disorders not thought to be caused by syphilis. The clinical features in those having neurosyphilis were sensorineural hearing loss (n = 5) and tabes dorsalis (n = 5). In the seven patients diagnosed with neurosyphilis who underwent CSF examination one patient had a reactive CSF-FTA, elevated protein, and elevated WCC; one patient had a reactive CSF-FTA and RPR with elevated protein; the total protein only was elevated in three cases and the WCC elevated in one case. Nine of the 10 patients with neurosyphilis received adequate neurosyphilitic treatment; one patient was lost to follow up. CONCLUSIONS: The management of patients with positive treponemal serology and psychiatric and/or neurological disorders was consistent. Patients with suspected neurosyphilis or patients with neurological signs compatible with neurosyphilis (who did not undergo CSF examination) were treated with adequate neurosyphilitic therapy.
Assuntos
Neurossífilis/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/etnologia , Doença de Alzheimer/microbiologia , Demência por Múltiplos Infartos/etnologia , Demência por Múltiplos Infartos/microbiologia , Feminino , Perda Auditiva Neurossensorial/etnologia , Perda Auditiva Neurossensorial/microbiologia , Humanos , Londres/epidemiologia , Masculino , Transtornos da Memória/etnologia , Transtornos da Memória/microbiologia , Pessoa de Meia-Idade , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/terapia , Encaminhamento e Consulta , Estudos Retrospectivos , Tabes Dorsal/etnologia , Tabes Dorsal/microbiologia , Índias Ocidentais/etnologiaRESUMO
Se describen las características de la Escala Isquémica de Hachinski en 29 pacientes afro-americanos y en 51 pacientes americanos de raza blanca. Los pacientes afro-americanos presentaron una mayor prevalencia de hipertensión arterial, así como valores más altos en la Escala Isquémica de Hachinski. Sin embargo, en el 93%(27-29) de los mismos la Escala de Hachinski mostró valores compatibles con el diagnóstico de una demencia degenerativa primaria. En una población racial mixta con una alta prevalencia de hipertensión arterial la Escala Isquémica de Hachinski clasificó correctamente a los pacientes afro-americanos con enfermedad de Alzheimer definida por los criterios del DSM III-R
Assuntos
Demência por Múltiplos Infartos/etnologia , Doença de Alzheimer/etnologia , Diagnóstico Diferencial , Hipertensão/complicações , Demência por Múltiplos Infartos/diagnóstico , Demência por Múltiplos Infartos/epidemiologia , Demência/diagnóstico , Demência/epidemiologia , Doença de Alzheimer/diagnóstico , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico , Testes Neuropsicológicos/estatística & dados numéricosRESUMO
Se describen las características de la Escala Isquémica de Hachinski en 29 pacientes afro-americanos y en 51 pacientes americanos de raza blanca. Los pacientes afro-americanos presentaron una mayor prevalencia de hipertensión arterial, así como valores más altos en la Escala Isquémica de Hachinski. Sin embargo, en el 93%(27-29) de los mismos la Escala de Hachinski mostró valores compatibles con el diagnóstico de una demencia degenerativa primaria. En una población racial mixta con una alta prevalencia de hipertensión arterial la Escala Isquémica de Hachinski clasificó correctamente a los pacientes afro-americanos con enfermedad de Alzheimer definida por los criterios del DSM III-R