Chapter 15 - Neurocognitive disorders and ageing

Question 1

What are neurocognitive disorders?

Answer 1

Significantly reduced mental abilities, relative to one’s prior level of functioning. Changes in cognitive functioning are the primary set of features.

Often associated with increased anxiety and depression as secondary features.

Question 2

What are the three types of neurocognitive disorders?

Answer 2

• Delirium
• Amnestic disorder
• Dementia

Question 3

What is delirium?

Answer 3

Impaired cognition and a marked change in awareness.

Question 4

What characterizes amnestic disorder?

Answer 4

Impaired memory while other mental processes remain intact.

Question 5

What is dementia?

Answer 5

Impaired memory plus one other impaired cognitive function such as perception, attention, or language use.

Question 6

What are the two types of intelligence in normal aging?

Answer 6

• Crystallized Intelligence
• Fluid Intelligence

Question 7

Define crystallized intelligence.

Answer 7

Relies on using knowledge to reason; assessed with verbal ability tests.

Question 8

Define fluid intelligence.

Answer 8

Relies on the ability to create new strategies to solve new problems; assessed with visual-motor skills, problem solving, and perceptual speed.

Question 9

At what age do test scores for cognitive functioning typically decline?

Answer 9

Scores decline at age 55, more significantly at 65.

Question 10

What is the duration of transient memory impairment in amnestic disorder?

Answer 10

Lasting a few days to a maximum of one month.

Question 11

What is confabulation?

Answer 11

Creating stories to fill in gaps in memory.

Question 12

What are common causes of amnestic disorder?

Answer 12

• Substance use
• General medical conditions

Question 13

What is delirium often described as?

Answer 13

A clouded state of consciousness.

Question 14

What are common symptoms of delirium?

Answer 14

• Trouble concentrating
• Vivid nightmares
• Perceptual disturbances
• Erratic emotional states

Question 15

What medical factors can affect cognition?

Answer 15

• Head injuries
• Prescribed and illicit substances
• Chronic medical conditions

Question 16

What is a stroke?

Answer 16

Interruption of normal blood flow to or within the brain, resulting in neuronal death.

Question 17

What are the two types of aphasia associated with strokes?

Answer 17

• Broca’s aphasia
• Wernicke’s aphasia

Question 18

What is the hallmark of Broca’s aphasia?

Answer 18

Problems in producing speech.

Question 19

What is the hallmark of Wernicke’s aphasia?

Answer 19

Problems in both comprehension of language and meaningful utterances.

Question 20

What are neurofibrillary tangles?

Answer 20

Mass created by tau proteins becoming twisted together, destroying microtubules in neurons.

Question 21

What are amyloid plaques?

Answer 21

Fragments of protein that accumulate on the outside surfaces of neurons, particularly in the hippocampus.

Question 22

What is vascular dementia?

Answer 22

Caused by reduced or blocked blood supply to the brain.

Question 23

What gene is associated with early-onset Alzheimer’s disease?

Answer 23

A gene controlling the protein responsible for the formation of beta-amyloid found on chromosome 21.

Question 24

What protective factors may reduce the risk of developing Alzheimer’s?

Answer 24

• Non-steroidal anti-inflammatory drugs
• Nicotine

Question 25

What is the cognitive reserve hypothesis?

Answer 25

The notion that high education levels delay the clinical expression of dementia.

Question 26

What is the impact of physical activity on mental function in older adults?

Answer 26

More physically active individuals are less likely to experience a decline in mental function.

Question 27

What treatments can help manage symptoms of dementia?

Answer 27

* Cholinesterase inhibitors * Memantine * Antipsychotics

Question 28

What is reality orientation therapy?

Answer 28

Focusing on the here and now by providing orientation cues.

Question 29

What are common symptoms of depression in older adults?

Answer 29

* More anxiety and agitation * Memory problems

Question 30

Who is at the highest risk of suicide among older adults?

Answer 30

Older White men who live alone.

Question 31

What is elder day care?

Answer 31

Day treatment for older adults with cognitive or physical impairments ## Footnote Elder day care provides education, support, and sometimes treatment for caregivers.

Question 32

How do depression symptoms in older adults differ from younger adults?

Answer 32

Older adults exhibit more anxiety and agitation, affecting attention, concentration, and mental processes, along with memory problems ## Footnote These differences can complicate diagnosis and treatment.

Question 33

Which demographic of older adults is at the highest risk of suicide when depressed?

Answer 33

Older White men who live alone ## Footnote This demographic has the highest suicide risk of any age group when experiencing depression.

Question 34

What is the prevalence of depression among older adults compared to younger people?

Answer 34

Under 3% in older adults, compared to as high as 20% in younger people ## Footnote Despite lower prevalence, depression accounts for nearly half of admissions of older adults to acute psychiatric care.

Question 35

What factors may lead to the underdiagnosis of depression in older adults?

Answer 35

Use of standard DSM-IV-TR criteria ## Footnote Older adults are less likely to demonstrate impaired social and occupational functioning due to lower workforce participation.

Question 36

What percentage of older adults with depressive symptoms were found to be medically ill in a survey?

Answer 36

44% ## Footnote This highlights the connection between physical and mental health in older populations.

Question 37

What is a hypothesized major risk factor for depression in the elderly?

Answer 37

Bereavement after the loss of a loved one ## Footnote The risk of depression is greatest in the first six months for widowers and in the second year for widows.

Question 38

True or False: Depression in older patients is more resistant to treatment than in younger patients.

Answer 38

False ## Footnote Claims of greater resistance are not substantiated.

Question 39

What were the three treatment types in the Blenker 1967 Study?

Answer 39

* Intensive treatment * Intermediate treatment * Minimal treatment ## Footnote Intensive treatment involved a nurse and a social worker, while minimal treatment consisted of information and referral to community services.

Question 40

What was the outcome of the intensive care group compared to the minimal care group in the Blenker study?

Answer 40

The death rate of the intensive-care group was four times that of the minimal-care group ## Footnote The intermediate-care group had a death rate twice that of the minimal-care group.

Question 41

What major factor contributed to excessive death rates in nursing home patients?

Answer 41

Whether or not a patient was placed in an institution ## Footnote Institutionalization increased the likelihood of higher death rates.

Question 42

What role does relocation play in nursing home patient outcomes?

Answer 42

Relocation is stressful and contributes to increased mortality ## Footnote The nature of care may discourage rehabilitation and self-care.

Question 43

What impact did emphasizing personal responsibility have on nursing home residents?

Answer 43

Residents showed improvement in alertness and increased behavioral involvement ## Footnote This included activities like movie attendance and socializing.

Question 44

What were the death rates of responsibility-induced residents compared to the control group after the intervention?

Answer 44

* 15% of responsibility-induced residents died * 30% of the control group died ## Footnote This indicates a significant improvement in health outcomes for those with induced responsibility.