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Junior Psychiatry > Aging And Old Age Psychiatry > Flashcards

Aging And Old Age Psychiatry Flashcards

1
Q

Ageing is a _________ deterioration of physiological function, an intrinsic-age related process of loss of ______ and increase in ____________

A

progressive

viability

vulnerability

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2
Q

The biological age of a person is identical to their chronological age

T/F

A

F

The biological age of a person is not identical to the chronological age

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3
Q

Loneliness is a major mental health problem of older adults

T/F

A

T

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4
Q

What are the Dimensions of Healthy Ageing?

A

Social activity
Diet
Genes
Productive pursuits
Exercise

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5
Q

Aging and the life cycle

Young adulthood: ________ vs ________

Middle aged : _________ vs __________

Elderly : ________ vs __________

A

Intimacy; isolation

Generativity; self absorption

Integrity ; despair

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6
Q

Fear of death is usually a _____ life issue

Acceptance of mortality occurs in _______ life

A

Mid

Elderly

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7
Q

What are the triple D’s in Elderly

A

Dementia
Delirium
Depression

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8
Q

Delirium :

Onset
Duration
Course
Consciousness
Attention and memory
Affect

A

Acute
Days to weeks
Flunctuating
Impaired
Inattentive, poor memory
Variable

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9
Q

Dementia :

Onset
Duration
Course
Consciousness
Attention and memory
Affect

A

Insidious
Months to years
Slowly progressive
Clear until late in the course of
Poor memory
Variable

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10
Q

Depression :

Onset
Duration
Course
Consciousness
Attention and memory
Affect

A

Variable
Variable
Diurnal variation
Unimpaired
Difficulty concentrating
Depressed

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11
Q

4 other psychiatric disorders of old age

A

Psychosis
Anxiety-phobias
Alcohol use
High risk of suicide

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12
Q

Late life Depression

Has a different presentation, usually __________ or __________

A

Happily Sad

Suffering with a smile

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13
Q

Late life depression

Could be a

Late onset depression ( first time after age ___)
_______ depression
__________ depression
_____________ depression

A

50

Vascular
Post stroke
Psychotic

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14
Q

Theories behind low prevalence of major depression in elderly??

A

Resilience
Shared experience or Generational temperament
Flaws in diagnostic approaches

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15
Q

Major depression in Elderly

Disturbances in sleep, appetite and sexual functioning are always reliable indicator

T/F

A

F

Disturbances in sleep, appetite and sexual functioning are not always reliable indicator

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16
Q

Major depression in Elderly

Use of _______,________, and ________ are useful in elderly primary care settings for screening

A

HAM-D, MMSE and GDS

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17
Q

Late onset depression has (more or less?) complete response to treatment

A

Less

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18
Q

Late onset depression have :

(Better or Poorer?) prognosis
_____eased mortality
(Acute or Chronic?) Course
_________ and _________ on scans

A

Poorer
Increased
Chronic
Frontal and temporal Atrophy

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19
Q

________ onset depression have more first degree relatives with depression (__________)

A

Early

Genetic loading

20
Q

Depression with reversible dementia, AKA __________ is now considered obsolete

A

Pseudodementia of depression

21
Q

Depression in the elderly is associated with cognitive impairments

T/F

A

T

22
Q

Depression with psychosis

Responds not Atall to ________
Poorly to _________ used alone
More often to combinations of ________ and __________ medications

A

placebos

antidepressants

antidepressants and antipsychotic

23
Q

Depression with psychosis

Hospitalizations is usually indicted and _____________ is the treatment of first choice when agitation, starvation, dehydration and suicidality threaten survival

A

electroconvulsive therapy

24
Q

Structural brain abnormalities are more frequent in patients with _____ onset depression than _____ onset depression

A

Late

Early

25
Q

Evidence is sufficient to recommend psychotherapy as a first line treatment for depression in older adults

T/F

A

F

Insufficient

26
Q

CBT
PST
IPT
DBT

A

Cognitive based therapy
Problem solving therapy
Interpersonal therapy
Dialectical behavior therapy

27
Q

Depression in elderly

Although approximately ____% to ___% of elderly patients improve clinically with antidepressant therapy.

The efficacy of these agents may be lowered , mainly in those with ___________ or _________________

A

50; 60

vascular

neurodegenerative brain disease

28
Q

______ is the most important of the non-phamarcological somatic treatments

A

ECT

29
Q

COURSE AND PROGNOSIS
> Left untreated, late-life major depression tends to remit spontaneously after ______________ , but patients with first-episode depression with onset after age 60 have a ____% chance of recurrence within ________.

A

12-48 months

70

2 years.

30
Q

Types of Delirium

????

A

Hyperactive/ Hyperalert
Hypoactive/ Hypoalert
Mixed

31
Q

Prescribed medicines can cause delirium

T/F

A

T

32
Q

Causes of delirium

I WATCH DEATH

A

Infections
Withdrawal
Acute metabolic
Trauma
CNS pathology
Hypoxia

Deficiencies
Endocrinopathies
Acute vascular
Toxins/drugs
Heavy metals

33
Q

The mortality outcome at 6 months post discharge for delirious patients not identified was ________ times higher than the delirious patients who were identified and treated

A

Three

34
Q

Adequate lighting is a treatment of delirium

T/F

A

T

35
Q

Dementia is an umbrella term used to describe a range of symptoms associated with cognitive impairments

List them

A

Alzheimer’s
Vascular
Lewy bodies
Frontotemporal

36
Q

Dementia is a syndrome due to disease of the _______, usually of a ———- and ________ nature

A

Brain

Chronic

Progressive

37
Q

Risk factors for dementia

Age: ________ years
• Gender: ______
• Prior stroke
• Atherosclerosis
• Heart disease
• High blood pressure
• Diabetes
• Diet

A

60-70

female

38
Q

Etiological classification o f dementia
• Neurodegenerative Diseases

• ___________ disease
> ___________ disease
• Diffuse ___________ disease
• Progressive ___________ ______
• Multisystem atrophy
• ___________ disease
• ___________ dementias

A

Alzheimer’s disease
> Parkinson’s disease
• Diffuse Lewy body disease
• Progressive supra-nuclear palsy
• Multisystem atrophy
• Huntington’s disease
• Frontotemporal dementias - e.g. Pick’s disease

39
Q

Frontotemporal dementias e.g. _____ disease

A

Pick’s

40
Q

Etiological classification o f dementia
•________ Diseases
•________ Disease or Trauma
• _________ Disease
•______________ Disease
• Other late-onset lysosomal storage diseases

A

Neurodegenerative

Structural

Vascular

Heredo-metabolic

41
Q

Etiological classification of dementia

Structural Disease or Trauma
•______________
• __________
• Dementia pugilistica

Vascular Disease
•_____________
•_____________

Heredo-metabolic Disease
•_________ disease
• Other late-onset lysosomal storage diseases

A

Normal pressure hydrocephalus

Neoplasms

Vascular dementia

Vasculitis

Wilson’s

42
Q

List 6 irreversible dementias

A

Alzheimer’s dementia
Lewy body dementia
Pick’s disease
Parkinson’s
Hungtington
Creutzfeldt-Jacob disease

43
Q

DEMENTIA

Findings on neuroimaging

Diffuse __________
• Enlargement of ________
• Widening of ________
• Atrophy more prominent in ___________
• There can also be evidences of strokes, lacunar infarcts, and white matter hyper intensities. These complicate the picture.

A

brain atrophy

ventricles

sulci and gyri

hippocampus

44
Q

Alzheimer’s disease VS vascular dementia

Prevalent sex
History of hypertension
Onset
Hypertension
Emotional lability
Cognitive deficits
Focal neurological signs

A

Women; men
Less common; more common
Gradually progressive ; episodic deterioration
Less common; more common
Less common; more common
Uniform; patchy
Uncommon; common

45
Q

Behavior and psychological symptoms of dementia (BPSD) include ????

A

Agitation, depression and psychosis

46
Q

BPSD are treatable
BPSD don’t respond well to therapy

T/F

A

T
F

47
Q

BPSD

50 - 90% of caregivers considered _______________ as the most serious problem they encountered and a factor leading to institutionalization

A

physical aggression

Junior Psychiatry (15 decks)

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