This study aimed to determine the reliability and validity of the Turkish version of Disability Assessment for Dementia (DAD) scale in the Turkish elderly population with Alzheimer disease (AD). The DAD scale was administered to the primary caregivers of 157 patients (age 77.7 ± 6.8 years) with AD. The Turkish version of the DAD scale showed high internal consistency (Cronbach α = .942), excellent test-retest, and interrater reliability (intraclass correlation coefficient [ICC] = 0.996 and ICC = 0.994, respectively). The DAD scale was significantly correlated with activities of daily living (ADL; Modified Older Americans Research Survey ADL) and instrumental activities of daily living (IADL; Lawton and Brody IADL) scales (r = .89, P < .001 and r = .90, P < .001). Disability Assessment for Dementia had a high negative correlation with the Global Deterioration Scale (GDS; r = -.880, P < .001). Post hoc comparisons with Tukey test showed significant differences in the mean DAD scores in different GDS stages. Construct validity was estimated using total score correlation analyses between the standardized Mini-Mental State Examination (MMSE) and the DAD scale. Results revealed high and significant correlation between MMSE score and DAD scale (r = .812, P < .001). The results of multivariate analysis showed that DAD score was not correlated with gender, education, and age. The DAD total score was affected mostly by GDS, MMSE, and duration of the disease. Turkish version of the DAD scale was found to be a reliable and valid instrument to assess functional disability in Turkish elderly patients with AD. This scale assists caregivers and physicians to decide for proper interventions.
Homes for the elderly in Turkey are not adequate in terms of consultations for psychiatric problems. Integration of these institutions with hospitals and organizing routine consultation visits from the psychiatry units would enhance the mental health of the elderly. Supporting the staff, maintaining good cooperation between them, and organizing educational programs in the field of mental health of the elderly are also required.
Objective: Neurofibromatosis (NF) is one of the most commonly seen autosomal dominantly inherited neurocutaneous syndromes. The most common subtypes are NF1 and NF2. The clinical course of NF may be heterogeneous.In this study, clinical features of patients with NF and its rare manifestations were described. Methods: Records of 11 patients with NF diagnosed between May 2008 and August 2011 were retrospectively reviewed. Demographic and clinical features of patients were detailed. Results: Six female and 5 male patients were enrolled. Patients' ages ranged between 1.5 and 58 years. Seven of them had positive family history for NF. A 1.5-year-old baby presented early appearance of Lisch nodules. One female patient had unilateral segmentally distributed pigmentary macules with bilateral Lisch nodules. Severe scoliosis and multiple painful neurofibromas were observed in a male patient. An asymptomatic arachnoid cyst was detected incidentally in a female patient. A male patient with NF1 had diffuse large B cell lymphoma and glioblastoma multiforme Conclusion: Patients with NF may present with diverse clinical manifestations. Since patients may first apply to a dermatology outpatient clinic with only cutaneous complaints, early diagnosis of NF both in the patients and in their first degree relatives by careful dermatological and ophthalmological examinations and radiological evaluations can be possible.
This prospective and hospital-based study was planned to investigate if bone mineral density (BMD) and bone mineral concentration (BMC) parameters are the risk factors of stroke and either there is an association between the parameters and other risk factors or not and importance of evaluation of location of osteoporosis. Total 42 female stroke patients and 24 female controls were included in the study. Each subject underwent BMD and BMC assessments. The sites studied are three regions of the femur, the distal third of the forearm, and the middle portion of the forearm. Other risk factors of stroke were recorded. The nature of the stroke was separated as hemorrhage and ischemia. The localization of lesion was determined. There were not significant difference for age between patients (mean age: 68.35 ± 15.29) and the controls (mean ± SD years: 66.37 ± 13.65) (p = 0.109). In the stroke group, the distal forearm BMD and BMC scores were less than the controls (p = 0.05 and p = 0.004). The great trochanteric BMC and BMD scores were significantly lower in the patients (p = 0.001; p = 0.036). Results indicate that measurement of in the proximal and distal portions of bones is a valuable non-invasive method for determining stroke risk.
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