title: High acceptability and low morbidity of diagnostic lumbar puncture in elderly subjects of mixed cognitive status.
abstract: A total of 273 participants (186 with clinical dementia; 87 "normal" controls; mean age 72 years) in a prospective, longitudinal, dementia research study, underwent lumbar puncture (LP), where possible, on an annual basis. Reporting of symptoms after all LP's (n = 541) was 21.6%, the predominant complaints being mild localised back-pain (12.8%) and headache (10.7%). All symptoms were self-limiting. Analysis of headaches after all first LP's (n = 273) revealed an incidence of 14.2% with marked differences between subjects under 60 years of age (33%) and those over 60 years (10.1%), between subjects with "minimal" cerebral atrophy (19.5%) and those with "significant" atrophy (5.6%) and, to a lesser extent, between subjects with no or mild cognitive impairment (20.6%) and those with significant impairment (9.5%). Age under 60 years and lack of significant cerebral atrophy were shown to be independent predictors of headache. Acceptability of LP was high as demonstrated by agreement to a second procedure by 92.2% of eligible subjects. Our results show that LP can be successfully incorporated into research with the elderly.
authors.affiliation: Oxford Project to Investigate Memory & Ageing, Radcliffe Infirmary, England.
authors.forename: N J
authors.initials: NJ
authors.lastname: Hindley
authors.forename: K A
authors.initials: KA
authors.lastname: Jobst
authors.forename: E
authors.initials: E
authors.lastname: King
authors.forename: L
authors.initials: L
authors.lastname: Barnetson
authors.forename: A
authors.initials: A
authors.lastname: Smith
authors.forename: A M
authors.initials: AM
authors.lastname: Haigh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000523:psychology; D001284:Atrophy; D001921:Brain / Q000473:pathology; D015331:Cohort Studies; D003704:Dementia / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006261:Headache / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012307:Risk Factors; D013129:Spinal Puncture / Q000009:adverse effects* / Q000523:psychology