chapter 16: aging and mental health Flashcards
Vulnerabilities to aging
- social isolation
- ## health anxiety
three theoretical models to help explain changes in mental health across adult life span
- Selective optimization with compensation (adapting goals to compensate for aging)
- socio-emotional selectivity theory (change motivation, emo regulation, and interpersonal functioning across lifespan. young=long term, goals old=short term)
- Strength and vulnerability Integration theory (limited time)
Summary of three models of why mental health is stronger with age
Each model contributes valuable insights into understanding age-related changes in mental health. SOC emphasizes adaptation and optimization, SST focuses on changes in goal orientation and emotion regulation, and SAVI integrates both strengths and vulnerabilities associated with aging. The choice of which model best explains improved mental health among older adults may depend on the specific context and factors being considered, as each model offers a unique perspective on the aging process.
what complicated a diagnosis of mental disorders in adults
- attribution of symptoms to age related factors
- comorbidity with chronic physical illnesses
- polypharmacy and med interactions
Well being is seen as ____ shaped across the lifespan
U-shaped
t or f: younger individuals are more likely to attempt suicide and more likely to be successful
false, younger individuals are more likely to attempt suicide but older adults are more likely to succeed (elevated risk can be due to: socio-demographics, pain, cognitive deficits)
what is depression often confused with for older adults
- early onset neurocognitive disorders
challenges with diagnosing depression in older adults
- time constraints
- physical comorbidy masking symptoms
- lack of knowledge of depression for seniors
- lack of specific diagnosis for older depression
- lack of effective treatment
most common sleep disorders in seniors
- insomnia (primary sleep prob causing significant impairment in daytime functioning, 3 nights/week for 3 months, predisposing risks, precipitating factors, perpetuating factors (cog/behavioural) treatment=drugs, therapy, combo CBT-I
- sleep apnea (5 episodes/night lasting 10 sec) increases w age, low blood oxygen saturation and awakening from sleep diagnosis=overnight polysomnography treatment= lose weight, dont sleep on back
age related changes in sleep
- changes in bedtime
- total sleep time decreased
- changes in EEG activity (lower amplitude of waves)
- changes in organization of sleep stages
- changes in circadian rhythms/sleep-wake cycles
t or f: anxiety is almost twice as common than depression in older adults
true, they are among the most common
most common anxiety disorders later in life
- specific phobia
- generalized anxiety disorder
- PTSD
- social anxiety disorder
diagnoses and treatment of anxiety in seniors
- difficulties in diagnosis: overshadowed by depression, lots of physical symptoms hard to separate, age differences but no change in assessment
- treatment: SSRI (first), CBT, mindfulness/relaxation based therapy,
Schizophrenia and age
- most (if not suicidal) have increase in positive symptoms and decrease in hospitalizations
- increased well being/quality of life
- overlapping symptoms (persecutory delusions) make it difficult for diagnosis
- treatment: antipsychotic drugs
Delirium
- neurocog disorder w sudden onset
- disturbances in levels of consciousnesses, attention, orientation, thinking, memory, perception, and behaviour
- etiology: infectious, metabolic, or structural
- diagnosis is often missed (detail history of patient is needed)
- reduced/clouded consciousness
treatment of delirium
- preventative efforts to reduce onset
- low-dose, short term psychotropic meds who are agitated/psychotic
- diagnosis and treatment of conditions due to delirium
neurocognitive disorder
- new term for dementia
- loss of cognitive function (memory, language, visuospatial, and reasoning ability)
MCI
- mild cognitive impairment
- no dementia but concern for abilities
- can often lead to NCD
____% of NCDs are attributed to Alzheimers
70
Alzheimers
- progressive, fatal, neuro disease
- average course of 6 years from diagnosis to death
- three stages: early (challenges w episodic memory, attention, concentration, finding words), middle (severe and wide range of symptoms, amnesia, aphasia, apraxia, agnosia, executive dysfunction), and late (profound impairment, hallucinations and delusions)
probable vs possible diagnoses for Alzheimers
- probable: family history and clinical evidence of declining memory, learning, and one other cognitive impairment that is gradual and progressive, and not caused by another neurodegenerative or medical issue
- possible: no family history but (2) above
Etiology of Alzheimers
- excessive amount of beta amyloid plaques and neurofibrillary tangles resulting in death of brain cells and shrunken cortex
Alzheimers vs neurocognitive disorders
- a: fatal disease, has NCD as well, most common type of NCD/dementia
-Nc: not always fatal
treatment of Alzheimer’s
- drugs (cholinesterase inhibitors)
- therapies to help manage challenges
Vascular NCD
- second most common cause of NCD
- arteries that supply the brain are partially blocked, causing stroke and lesion
- diagnosed through neuroimaging
____ medication may be prescribed to folks with Vascular NCD to prevent likelihood of future strokes
blood thinner
NCD with Lewy bodies
- progressive decline in cognitive functions
- different symptoms: hallucinations, fluctuating cognition, spontaneous features of Parkinsonism
- some can die from antipsychotics
frontotemporal NCD
- heterogenous group of disorders that affect frontal and temporal lobe
- intact memory until later in progression
- personality changes
