Ageing And Psychological Disorders

Question 1

Primary ageing

Answer 1

Changes that occur due to the passage of chronological time (normal changes associated with ageing eg grey hair, poor eyesight).

Question 2

Secondary ageing

Answer 2

Changes that are not a normal part of ageing and includes disease states and mental health (eg dementia and depression).

Question 3

Cognitive changes with increasing age

Answer 3

Attention: complex attention declines
Memory: lapses in memory are normal. Semantic memory stays intact better than episodic memory.
Language: most robust in the face of ageing.
Executive functioning: declines, but is maintained by physical activity.
Wisdom: improves with age.

Question 4

Theoretical accounts of age-related cognitive changes

Answer 4

Declines in information-processing capacity cause tasks that require effort full processing to decline.
Frontal lobe theory: frontal lobe deterioration occurs in later life, affecting higher order processes.

Question 5

Mood in later life

Answer 5

Now generally accepted that depression and most other psychiatric conditions decrease in incidence in later life.
Research suggests this may be partly due to increase coping strategies for managing distressing emotions.
Better emotional regulation in older people may account for greater levels of wellbeing.
Emotional states generally improve with increasing age.

Question 6

Personality in later life

Answer 6

Personality tends to be pretty stable over adult life.

Erikson says personality changes (integrity vs despair).

Question 7

Social changes with age

Answer 7

Older adults are satisfied with relationships.
Social pruning: meaningful and fulfilling relationships take priority.
It is the perceived amount of social support received that predicts satisfaction with one’s relationships.
Social networks are important in helping older adults cope with adversity.
Women give and receive more social support than men.

Question 8

Dementia and neurocognitive disorder

Answer 8

Dementia refers to a broad class of neurological disorders associated with cognitive, personality and behavioural changes in later life. 
The DSM-5 has eliminated the term dementia and replaced it with major or mild neurocognitive disorder.

Question 9

Major neurocognitive disorder

Answer 9

Involves a substantial level of cognitive decline from previous functioning (includes diagnoses such as dementia).

Question 10

Mild neurocognitive disorder

Answer 10

Describes a level of cognitive decline that is more than what is expected in normal ageing but not yet at the level of a major neurocognitive disorder.

Question 11

Features of dementia (Alzheimer’s diseases)

Answer 11

Memory impairment and one or more of:
Aphasia (language not meaningful, comprehension or words)
Apraxia (motor tasks)
Agnosia (recognise and identify objects)
Executive function deficits (planning, organising, sequencing, and obstruct thinking).
Cause significant functional impairment and a decline from previous functioning.
Not the result of delirium or other mental disorders or physical disorders.

Question 12

Alzheimer’s disease

Answer 12

The most common form of dementia. 
Represents 50-70% of cases of dementia diagnosed. 
Average age of onset is 65. 
Lifespan of 8-10 years following onset. 
Women slightly higher risk. 
Characterised by abnormal brain changes.

Question 13

Alzheimer’s disease: symptoms

Answer 13

The course of the disease is characterised by increasing cognitive dysfunction, including difficulties in remembering new information and in naming objects, people and places.
Delusions and hallucinations often present.
Changes in personality such as apathy, agitation, and behavioural problems such a wandering occur.

Question 14

Alzheimer’s disease: levels of severity

Answer 14

Mild: memory impairment, word finding difficulties, executive dysfunction.
Moderate: continued deterioration of above. Reduced spatial and motor function.
Severe: unresponsive. Eventually lose ability to remember to eat, swallow, breathe.

Question 15

Aetiology of Alzheimer’s disease

Answer 15

Genetic inheritance and family history (ApoE gene).
Cardiovascular risk factors (heart disease, smoking).
Cognitive ability may be relevant.

Question 16

Vascular dementia

Answer 16

The second or third most common form of dementia.
10-30% of all cases.
The three most common causes are multiple cortical infarcts (stroke), single cortical infarcts and small vessel disease in the brain.
It has more of a sudden onset than Alzheimer’s disease.

Question 17

Frontotemporal dementia

Answer 17

Involves prominent changes in personality and behaviour. 
Earlier onset (40-60). 
Memory decline later.

Question 18

Lewy body dementia

Answer 18

Involves fluctuation in attention and alertness, complex visual hallucinations and features of Parkinson’s (shakes and tremors).
Poor visuospatial abilities.
Fluctuations in cognitive function.
Sleep abnormalities.

Question 19

Assessment, treatment and prevention of dementia

Answer 19

Early diagnosis involving comprehensive assessment associated with optimal treatment outcomes.
Current work on developing a vaccine that would slow the progression of the illness.
Psychological and behavioural interventions effective in managing some of the challenging symptoms.
Carers play an important role.

Question 20

Late-life depression

Answer 20

Onset after the age of 60.
Experience significant cognitive dysfunction.
Increased comorbidity of medical illnesses.
Higher rates of either lethargy or agitation.
Tends to be quite chronic and resistant to treatment.
Highest frequency of suicide.
CBT, reminiscence therapy and interpersonal psychotherapy are effective treatments.

Question 21

Retirement

Answer 21

Generally a positive transition.
Higher income, better psychosocial variables and organisation factors are possible predictors of positive retirement adjustment.

Question 22

Successful ageing

Answer 22

Baltes’ theory of selection(identifying and prioritising goals), optimisation (maximising performance to ensure successful achievement of the goal) and compensation (adapting to limitations that hinder the pursuit of goals) proposes that individuals who age successfully use these three strategies.

Question 23

Grandparenting

Answer 23

Both positive and negative outcomes.
More likely to experience depression, diabetes, hypertension and insomnia.
Dealing with grandchildren’s emotional distress and hyperactivity can lead to stress, anxiety and depression.
Feel closer to their grandchildren, give meaning to their own lives.

Question 24

Bereavement

Answer 24

Common among older adults, but does not necessarily result in clinically significant psychological distress.
Tend to have good support networks.
Death is somewhat expected.

Question 25

Positive ageing

Answer 25

Low risk of disease and disability.
High levels of mental and physical functioning.
Active engagement with life.
Positive view of oneself and the world.