Chapter 15 - Neurocognitive disorders and ageing Flashcards
What are neurocognitive disorders?
Psychological disorders with a primary symptom of significantly reduced mental abilities relative to one’s prior level of functioning.
What is the main difference between normal and abnormal cognitive changes as we age?
Normal cognitive changes are mild, like slower thinking or occasional forgetfulness, but don’t interfere with daily life.
Abnormal cognitive changes are severe, frequent, and disrupt daily tasks, like getting lost in familiar places or forgetting important personal info.
What is Crystallized Intelligence?
Using knowledge to reason in familiar ways, knowledge is crystallized from previous experience, remains stable and increases with age
What is Fluid Intelligence?
Relies on creating new strategies to solve new problems, relies on executive functioning (abstract thinking, planning and good judgment), begins to decline with older age
What does working memory require and which part of the brain is responsible for it?
Working memory requires keeping information active while working with it (like counting backward by 3s from 100).
List three common working memory problems older adults face due to normal aging.
Slower mental processing
Difficulty sustaining and dividing attention
Trouble recalling and holding information in working memory
Why do older adults need more exposure and practice when learning new information?
Because their slower processing speed makes learning new material slower, and they need repeated exposure and practice to help with memory retrieval.
How does multitasking ability change with age?
Multitasking declines with age because older adults struggle to sustain and divide attention between tasks.
What does the Trail Making Test show about aging and cognitive speed?
It shows that processing speed and attention slow with age.
A 25-year-old averages 26 seconds, while a 72-year-old averages 70 seconds to complete the task.
How does depression in older adults differ from depression in younger adults?
It’s less likely to be diagnosed in older adults and shows different symptoms like more anxiety, agitation, and memory problems.
How does depression affect cognitive functioning in older adults?
Cognitive functioning is affected both:
Directly: Depression impairs thinking and memory.
Indirectly: Anxiety and agitation reduce concentration and memory.
What is aphasia and what does it affect?
Aphasia is a medical condition that causes problems using language, either in speaking or understanding.
What is Broca’s Aphasia, and what are its main symptoms?
Broca’s Aphasia causes problems producing speech — speech is slow, choppy, and telegraphic (only main words, omitting little words like “and,” “or,” “of”).
It’s often caused by damage to the frontal lobe.
What is Wernicke’s Aphasia, and how does it affect speech?
Wernicke’s Aphasia causes problems comprehending language and producing meaningful sentences. Speech sounds fluent, but the words often don’t make sense.
e.g., “Well, the toaster flew over the library because the happiness purple drives swimmingly.”
What is agnosia?
Agnosia is when a person has problems understanding what they perceive, even though their senses and knowledge about objects are normal.
What is prosopagnosia and what does it affect?
Prosopagnosia is the inability to recognize faces — even though vision and memory are fine, the brain can’t match a face to a person.
What is apraxia?
Apraxia is a problem with carrying out voluntary movements (like walking or using your fingers) even though the muscles are not impaired — the issue is in the brain
In apraxia, why can’t people perform certain movements even though their muscles work?
Because the problem isn’t with the muscles — it’s caused by brain damage that disrupts the brain’s ability to plan or control movements.
What is delirium and who is most commonly affected?
Delirium is a disturbance in attention and awareness, along with disruption in at least one other aspect of cognitive function.
It’s most common in the elderly, terminally ill, and post-surgical patients.
How do delirium symptoms develop and change over time?
Symptoms develop rapidly and can fluctuate — meaning they may come and go or get worse and better in short periods.
What are the attention and awareness issues seen in delirium?
People with delirium have decreased awareness of their surroundings and trouble paying, maintaining, and shifting attention. They may seem distracted and unable to concentrate.
What kind of perceptual changes are common in delirium?
Delirium often causes visual misinterpretations, illusions, and hallucinations.
What are some other effects of delirium on mood and behavior?
People may have difficulty with sleep cycles, restlessness, agitation, and mood swings.
What is dementia?
Dementia is a general term for a group of neurocognitive disorders, characterized by deficits in learning new information or recalling learned information, plus at least one other cognitive impairment.
How do symptoms of dementia develop over time?
Symptoms of dementia appear slowly and can change as brain function declines. They may either worsen or remain stable over time.
Can dementia arise from a medical condition?
Yes, dementia can arise from various medical conditions, including Alzheimer’s disease, Parkinson’s, HIV infection, Huntington’s, head trauma, and substance-induced dementia.
What is the most common cause of dementia?
The most common cause of dementia is Alzheimer’s disease.
What percentage of dementia cases are caused by Alzheimer’s disease?
Alzheimer’s disease accounts for about 3/4 of dementia cases.
How do the symptoms of Alzheimer’s disease change over time?
The severity of symptoms increases over time — early symptoms include irritability, personality changes, wandering, and confusion. In later stages, individuals may have difficulty walking, talking, and with self-care.
How long does a person with Alzheimer’s typically live after symptoms start?
Death typically occurs within 8-10 years of symptom onset.
How is Alzheimer’s disease diagnosed?
Alzheimer’s is diagnosed by ruling out other causes. It is not a straightforward diagnosis and requires thorough testing.
What are neurofibrillary tangles, and how do they affect the brain?
Neurofibrillary tangles are masses created by tau proteins that twist together and destroy microtubules, leading to a breakdown in the brain’s nutrient supply system.
What are amyloid plaques, and where do they accumulate in Alzheimer’s disease?
Amyloid plaques are protein fragments that accumulate on the outside of neurons, especially in the hippocampus, disrupting brain function.
What is Parkinson’s disease characterized by?
Parkinson’s disease is characterized by slow, progressive loss of motor function, including trembling hands, shuffling walk, and muscular rigidity.
What percentage of people with Parkinson’s disease will develop dementia?
Approximately 50% of people with Parkinson’s disease will develop dementia due to the disease.
How does Parkinson’s disease affect the brain?
Parkinson’s disease causes damage to dopamine-releasing neurons in the substantia nigra, leading to a lack of dopamine, which affects motor control and cognitive function.
What cognitive deficits are commonly seen in Parkinson’s disease?
Executive functioning deficits are common, affecting a person’s ability to plan, organize, and carry out tasks.
How does dopamine treatment affect symptoms of Parkinson’s disease?
Giving extra dopamine can greatly improve motor function symptoms of Parkinson’s disease, but it may not fully address cognitive issues like dementia.
What is the substantia nigra, and why is it important?
The substantia nigra is a part of the midbrain that makes dopamine, a chemical that helps control movement.
In Parkinson’s disease, these cells die, causing problems like tremors, slow movement, and muscle stiffness.
How does HIV infection cause dementia?
HIV destroys white matter and subcortical brain areas, causing memory problems, concentration issues, tremors, and behaviour changes.
How can dementia from HIV infection be treated?
Antiretroviral medication can slow or even reverse brain damage and improve cognitive functioning.
