aging and mental health Flashcards
Issues in Aging
-Aging may have a great negative impact for women or minorities
-Ageism refers to discrimination against any person based on age (can be young or old person)
Diversity in Aging
-Levels of “old”
-Young-old: ages 65-74
-Old-old: ages 75-84
-Oldest-old: over age 85
Measurement Issues in Aging Research
- Age effects are the consequences of being a given chronological age
- Retirement, Social security- Cohort effects are the consequences of having been born in a particular year and having grown up during a particular period of time
- Great depression, World War II
- Time-of-measurement effects are confounds that arise because particular historic events have specific effects
- Cohort effects are the consequences of having been born in a particular year and having grown up during a particular period of time
Psychological Issues in Aging
- Problems can arise from
- Many common pressures found during that time of life
- Unique traumatic experiences
- Neurocognitive disorders=biological abnormalities - Geropsychology is the field of psychology dedicated to the mental health of elderly people
- Booming industry
The psychological problems of divided into two groups
Disorders that may be common in people of all ages but are connected to the process of aging
- Depressive, anxiety, and substance use disorders - Often recurrences from earlier psychological problems - Can be first episodes - Disorders of cognition that result from brain abnormalities - Delirium, mild neurocognitive disorders, and major neurocognitive disorders
Dementia
refers to a gradual deterioration of intellectual ability that interferes with social and occupational function
- Also called neurocognitive disorder - most publicized and feared psychological problems among the elderly - Dementia can involve problems in - Memory - Poor hygiene - Language disorder - Faulty judgment - Delirium (state of mental confusion)
Alzheimer’s Disease
- Alzheimer’s Disease involves a progressive deterioration of the cerebral cortex and hippocampus leading to difficulty in concentration and pronounced memory loss
- Alzheimer’s disease involves
- Loss of nerve cells within brain due to plaque formation and neurofibrillary tangles
- Reduced activity of the neurotransmitter acetylcholine (ACh)
- Alzheimer’s disease involves
- Most common form of dementia
- most often occurs after the age of 65
- Its prevalence increases markedly among people in their late 70s and early 80s- The time between onset and death is typically 8 to 10 years, although some people may survive for as many as 20 years
- It usually begins with mild memory problems, lapses of attention, and difficulties in language and communication
- As the symptoms of dementia intensify, people sow less and less awareness of their limitations
- Eventually they become fully dependent on other people
- The late phase of the disorder can last from 2 to 5 years
Factors that may prevent Alzheimer’s
Anti-inflammatory drugs such as ibuprofen
- Nicotine - High levels of cognitive ability - Maintaining high levels of cognitive activity - No cure for disease
Frontal-Lobe Dementias
Frontal-Temporal dementia (a.k.a. known as Pick’s disease)
-Cognitive impairments of memory not as severe as Alzheimer’s
-Apathy
-Loss of serotonin neurons in brain (rather than ACh)
-Impairment of executive functions
-Planning
-Problem solving
-Goal directed behavior
-Difficulty recognizing emotion
Frontal-Subcortical dementias include:
-Parkinson’s disease (muscle tremors)
-Huntington’s disease (muscle writhing)-inherited
-Vascular dementia (muscle weakness-stroke)
- -Multi-infarct dementia- multiple mini-strokes
-Vascular dementia
(multi-infarct* dementia)
- May follow a cerebrovascular accident, or stroke, during which blood flow to specific areas of the brain was cut off, with resultant damage - This dementia is progressive but its symptoms begin abruptly, rather than gradually - Cognitive functioning may continue to be normal in the areas of brain not affected by the stroke - This is the second most common type of dementia among the elderly * infarct=dead tissue resulting from loss of oxygen/blood supply
Other causes of dementia
- HIV infections
- Traumatic brain injury (old and new)
- Substance abuse (long term and acute)
- Various medical conditions such as meningitis or advanced syphilis
Treatment of Dementia
Alzheimer’s Disease has no treatment to halt or reverse the disease
-Drug studies seek to boost remaining ACh function in brain using
-Drugs that block the breakdown of ACh
-Drugs that block the formation of B-amyloid
-Drugs are used to treat the specific symptoms of Alzheimer’s disease (depression, anxiety, sleep disorder)
Psychological therapy is to be supportive
-Treat families
Delirium
Delirium is a clouded state of consciousness involving
-Difficult in concentration
-Disruption of the sleep-waking cycle
-Incoherent speech
-Memory impairment for recent events
-Perceptual disturbances (delusions and hallucinations)
-Mood/activity swings
As a person’s awareness of the environment becomes less clear, he or she has great difficulty concentrating, focusing attention, and thinking sequentially
-This leads to misinterpretations, illusions, and on occasion, hallucinations
Must be treated as a medical issue
-Always has a physical cause
Comes on SUDDENLY
Cause of Delirium
- Drug intoxications and drug-withdrawal reactions
- Side effects
- Polypharmacy -Practice of prescribing multiple drugs to patients
- especially problematic when seeing multiple providers
- Metabolic/nutritional imbalances (diabetes)
- Infections (fevers)
- Stress (environmental change)
- Major surgery
- Brain damage
Summary of Brain Disorders in Old Age
Dementia
gradual deterioration of cognitive ability that interferes with social and occupational function
- Organic cause and is progressive - Can involve problems with - Memory (short and long term) - Activities of Daily Living (ADLS) - Language Disorder (Dysnomia) - Reasoning and higher cognitive function (judgment) - Delirium (state of mental confusion)
Summary of Brain Disorders in Old Age
Delirium
clouded state of consciousness involving
- Organic cause, but is transitory and reversible - Can involve - Difficulty in concentration - Disruption of the sleep-waking cycle - Incoherent speech - Memory impairment of recent events - Perceptual disturbances - Mood activity swings - 40% mortality rate because of what is causing the delirium
Depression in the Elderly
The prevalence of mood disorders is less in the elderly (<3%) than in young people (20%)
- Bipolar depression is rare in the elderly - Symptoms of depression are similar in the elderly except that feelings of guilt are less common and somatic/memory complaints are more common - Suicide attempts and completions increase for men as they age
Causes of Depression in the Elderly
Depression in the elderly is associated with
- Poor physical health - Medications that aggravate existing depression - Antihypertensive medications - Hormones - Corticosteroids - Anti-Parkinson medications - Stressors
Depressive Pseudo-dementia
-Forgetfulness
Reversible with treatment with underlying depression
Anxiety Disorders in the Elderly
Anxiety disorders are more common than depression in the elderly
-Anxiety per se is quite common in the elderly
Anxiety is associated with
-Medical illness or anticipation of illness
-Medication reactions
-Delirium accompanying illness
-Cardiovascular conditions (angina)
-Caffeine consumption
Schizophrenia in the Elderly
Prevalence of schizophrenia is lower in the elderly than in the young
- Schizophrenics die young - Some schizophrenics show remission of the symptoms as they enter old age - Schizophrenia rarely has an onset after age 60 - Paraphrenia is the term used to characterize the onset of schizophrenic symptoms in an older person (more hallucinations and delusions)
Psychotic Disorders in Later Life
delusional disorder, in which individuals develop beliefs that are false but not bizarre
- This disorder is rare in most age groups, but its prevalence appears to increase in the elderly population - Some clinicians suggest that the rise is related to the deficiencies in hearing, social isolation, greater stress, or heightened poverty experienced by many elderly persons
Sleep Disorders in the elderly
Insomnia is a common (25%) sleep problem in the elderly Other common sleep problems include -Frequent awakenings at night -Early morning awakenings -Difficulty falling asleep -Daytime fatigue
