血管性认知功能障碍与胰岛素抵抗关系的临床研究

探讨在血管性认知功能障碍（vascular cognitive impairment,VCI）的发病机制中胰岛素抵抗（insulin resistance,IR）的作用及二者之问的关系。比较41例VCI患者与80例健康对照组中空腹血糖（FPG）等13个因素之间是否存在差异,及VCI的发生与上述各因素之间的关系。VCI组FPG、FINS、HOMA-IR、ISI、FIB、TC、TG、LDL明显高于对照组（P〈0．01或P〈0．05）;其中FINS、HOMA-IR、LDL为VCI发生的危险因素;MMSE评分与ISI呈显著正相关（rs=0．56,P〈O．01）。VCI中存在IR,IR是VCI发生的危险因素之一,VCI的严重程度与IR呈正相关。     

Naturalizing Myths of Aging: Reading Popular Culture

This essay blends distinct fields of study--namely semiotics, gerontology, geriatrics, and the critical analysis of dramatic and filmic comedy of the modern era--in a way that we hope sheds light on the perception of elders both in our cultural tradition and in our current society. By bringing to bear these disciplines on this issue, we attempt to expose one way that erroneous perceptions about the elderly--myths, if you will--are propagated. Why is it, for example, that the majority of Americans have generally negative attitudes towards elders and the aging process despite the fact that such stereotypes are all contradicted by reality (Palmore, 1990)? What is it that we fear--and perhaps loathe--when it comes to our aging ? And why are we so irrational about this topic? How do myths of aging originate? And whose agenda might they serve? Is there some effective way that these myths can be defused in the popular mind? The above are all problematic questions, some with potentially disturbing answers. Yet we believe that by beginning to understand the linguistic and perceptual mechanisms by which myths of aging come into existence, a crucial first step will be taken toward understanding the source and the scope of the myths themselves. Perhaps only then will we be, as a society, in a position to countermand these usually harmful and often destructive misconceptions about our elderly population.     

The structures of the WISC-R subtests: a comparison of the IQ-profiles of reading impaired and autistic subjects

The present paper is an analysis of the WISC-R test profiles of reading impaired subjects and autistic subjects. It is argued that well-known classification systems such as Bannatyne's categories (1974) and Kaufman's factors (1975) cannot explain differences in the peaks and troughs across the two populations. A new classification system is then developed. The 11 different WISC-R subtests are characterised in terms of a combination of three modes of cognitive functioning: a knowledge mode (declarative-procedural), a processing mode (transformation-preservation of information), and a verbal-nonverbal mode (verbal-nonverbal-processing). When reanalysed within this reference frame, the IQ profiles of reading impaired subjects (N = 114) and autistic subjects (data from 12 studies reviewed by Happé, 1994) were similar regarding differences in the verbal-nonverbal dimension. However, the IQ profiles showed an opposite pattern in the declarative-procedural dimension, and an opposite pattern in the preservation-transformation dimension. Thus, the new classification system allows one to interpret the IQ-profiles of both groups within a single and coherent reference frame.     

Parent's report of stress and articulation oscillation as factors in a preschooler's dysfluencies

Recently, one focus of research on dysfluency and stuttering seems to be on the preschooler. One goal of such research should be to determine what factors in the child's language system and what factors in the social environment may put the child at risk for developing dysfluencies and stuttering. The following is a parent's account of the occurrence of dysfluencies in a preschooler. Emphasis is on a language phenomenon that might be labeled “articulation oscillation” and on apparent social environmental stress.     

Screening for cognitive impairment in an Australian aged care assessment team as part of comprehensive geriatric assessment

Accurate detection of mild cognitive impairment (MCI) is important to stratify and address risk. Yet, few short cognitive screening instruments are validated for this. . In Australia, all clients referred to an Aged Care Assessment Team (ACAT) receive comprehensive geriatric assessment (CGA) including the Standardized Mini-Mental State Examination (SMMSE). We compared the accuracy of the quick mild cognitive impairment (Qmci) screen to the SMMSE in 283 participants: 195 with dementia, 47 with MCI, and 41 with subjective cognitive decline (SCD) in an Australian community-based ACAT. Both had similar accuracy in identifying dementia, AUC of 0.86 for the Qmci versus 0.93 for the SMMSE (p = 0.10), but the Qmci was more accurate than the SMMSE in differentiating MCI from SCD, AUC of 0.84 versus 0.71, respectively, p = 0.046. These suggest that the new, short (3–5 min) Qmci screenis appropriate for use in an ACAT or other units conducting CGA.