Aging Flashcards
What are the two theories thought to explain aging?
Programmed theories
Damage or Error Theories
Reasons why the brain is more susceptible to aging?
Slow, limited cell division
Damaged areas
High levels of energy production and usage results in more oxidative stress
What are the structural changes to the brain (normal aging)?
Atrophy
Reduced capillary density
Metabolic changes
What are atrophic changes with brain aging?
Loss of neurons
Decreased axon diameter
Reduced myelin sheath thickness
What are vascular changes with brain aging?
Reduced capillary density
- Thickening of vessel walls and basement membrane
What are metabolic changes with brain aging?
Reduced insulin receptor sensitivity (hippocampus)
Reduced glucose and oxygen use
What type of brain matter decline with aging?
Gray = declines linearly
White = peaks in midlife before declining
What’s a likely reason for age-related cognitive slowing?
Likely compounded by declining frontal lobe function and neuromuscular control
Is age-related cognitive slowing part of normal aging?
Yes
What type of activity is critical in maintaining cognitive performance?
Mental and physical
Is the global cognitive assessment for specific testing?
No, a broad population-level screening
2 main types of cognition?
Hot = emotions and motivation
Cold = information processing
Who can administer the global cognitive assessment?
Any member of the health care team
Is the global cognitive assessment diagnostic?
No
Global Cognitive Assessments
Brief pencil/paper tests to assess general mental status
Used for population-level screening
Can be administered and interpreted of health care team (no level of training req)
Common Global Cognitive Assessments
Mini-Mental Status Exam
Montreal Cognitive Assessment
Mini-Cog Test
Clock Drawing Test
AD8 Dementia Screening Tool
What is executive function?
Ability to plan, organize, sequence and monitor goal-oriented behaviors
How is executive function typically assessed?
By the change in performance from simple to complex conditions
Associated to falls and functional deficits
3 main activities involved with executive function?
Updating ability
Shifting ability
Inhibition ability
Shifting-Specific Executive Function
Reflect flexibility in transitioning to new task-set representations
Updating-Specific Executive Function
May be related to information gating and retrieval from long term memory
Clinical Manifestation of impaired inhibition
Impulsivity
Inhibition
Suppression of an automatic or predominant response
Means by which habit and familiarity can be over-ridden
Updating
Use of incoming information to update older, irrelevant information
Updating is related to and associated with which 1) components and 2) activation areas of the brain?
Working memory and intelligence
Associated with dorsolateral prefrontal cortical activation
Shifting
Transfer of attention b/t multiple tasks or mental states
What does shifting require?
Requires disengagement from irrelevant task set, with engagement of more relevant task set
Clinical Manifestation of shifting issues
- Perseveration
Test for Inhibition
Stroop Color Word Test
Tests for Shifting
Navon (local/global) figures
Trail making test
Is there a brain region for multitasking?
NO, brain activity is task specific
Dual Task costs
Can do two tasks at once but not well
Disruption in task performance under dual-task conditions
Multitasking Tests
Cognitive TUG (subtraction counting while walking)
Walking and remembering test
3 aspects of dementia
Significant decline in one or more cognitive areas
Interference with everyday function
Not explained by delirium or other mental disorder
Examples of cognitive decline that can manifest with dementia
Learning + memory
Executive function
Language
Complex attention
Perceptual-motor
Social cognition
Common age-related cognitive changes
“tip of the tongue syndrome”
Decline in working memory
Slower processing
Stable vocabulary
No appreciable interference with ADLs
Best diagnostic test for dementia
Careful hx and physical and mental status exam by a knowledgeable physician
