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Geropsychology > Chapter 6 > Flashcards

Chapter 6 Flashcards

1
Q

Introduction

A

• Older ppl less likely to suffer from mental health than any other

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2
Q

Mild cognitive impairment

A
  • Mild cognitive impairment (MCI): no dementia, but decline in everyday life
  •  cognitive impairment, not dementia (CIND) CNID: all cases of impairment, regardless of whether individual has sought medical attention
  • MCI just prodromal dementia?
  • Smoking gun symptom: symptom that unambiguously indicates one illness and one illness only
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3
Q

Dementia

A
  • Decline in intellectual functioning must include decline in memory plus at least one other cognitive skill
  • Early-onset dementia (EOD): before age 60
  • Doubling of cases every 5 years
  • 50 types of dementia, not only Alzheimers
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4
Q

Functional impairment

A
  • Blessed dementia scale (BDS)
  • Mental Status Questionnaire (MSQ)
  • Mini-Mental State Examination (MMSE)
  • FAST (Stages, Reisberg)
  • Clinical Dementia Rating (CDR)
  • Agitation increases in dementia patients
  • Aetiologies  different types of dementia
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5
Q

Alzheimer’s Disease

A

• Senile dementia of the Alzheimers type (SDAT), primary degenerative dementia (PDD), dementia of the Alzheimers type (DAT)
• Short term memory decline
• Apraxia, visual agnosia (inability to recognize by sight)
• Aphasia (Broca/Wernicke)
• Demented dyslexia
• Parkinsonism
• Kluver-Bucy syndrome: hyperorality (put everything in mouth) bulimia, hypermetamorphosis (urge to touch everything), loss of affect
• NINCDS-ADRDA criteria: probable, possible, definite
• Diagnosis by default just ruling out other symptoms
• Senile dementia
• Senile plaques in brain with AD
• Neurofibrillary tangles Axons keep structure thanks to tau, in AD tau becomes distorted, axons form tangles, communication between neurons lost
Cell loss in cortex amygdala, hippocampus, brain stem
• Loss of neurons in cholinergic system
• Cholinergic hypothesis: suppressing cholinergic activity impairs memory, therefore has role in AD
• Cognitive reserve
• Apolipoprotein E (ApoE): gene that increases risk for AD
• Amyloid precursor protein (APP), presenilin-1, presenilin-2
• No genetic cause twin studies
• Threshold model of dementia: persons genetic make-up may predispose them to develop DAT, but requires environmental triggere.g. vascular disease, aluminium
• Kuru

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6
Q

Vascular dementia

A
  • Vascular dementia (VaD): umbrella term, caused by damage to blood vessels in brain
  • Thrombosis, embolism, haemorrhage infarct
  • Single-infarct/multi-infarct dementia multi= majority
  • Mixed dementia
  • Cortical atherosclerotic dementia, subcortical…
  • Lacunar strokes
  • Binswangers disease
  • Hachinski Ischaemic Score (IS)
  • Characteristic of VaD: stepwise: sudden decline, no change or recovery, another sudden decline…
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7
Q

Other dementias

A
  • Frontotemporal dementia –> subtype: Pick’s disease (behavioral variant frontotemporal dementia), neurons degenerate into Pick’s bodies
  • Confabulating: making up stories to cover up gaps in memory
  • Semantic dementia (temporal variant frontotemporal dementia)
  • Creutzfeldt-Jakob disease (CJD): first movement, then intellectual deteriorationBSE
  • Huntingtons disease
  • Parkinsons disease (PD)
  • Dementia with Lewy bodies (DLB)
  • Normal pressure hydrocephalus
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8
Q

Cortical and subcortical dementias

A

• Cortical: AD, Pick,

Sub: PD, Huntingtons (VaD: both grops)

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9
Q

Illnesses that can be confused with dementia

A

• Reversible dementias: pseudodementia ( depression), Delirium (acute confusional state ACS)  hypoactive/hyperactive/mixed delirium short attention span, illusionsDelirium Rating Scale Delirium also occurs in demented patients

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10
Q

Incidence rates for subtypes of dementia

A
  • AD much more common than VaD
  • Late onset dementia (LOD)
  • AD more commo in women, VaD more common in men
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11
Q

Memory changes in dementia

A
  • LTM: deficit in encoding
  • Phonological loop unscathed in early stage of disease, later becomes impaired
  • Key deficit in central executivefrontal lobe
  • Autonoetic consciousness: awareness of oneself in memories and the ability to travel back in time through memories impoverished in dementia patients
  • Temporal gradient: memories from one time of life better remembered than others
  • Anxiety
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12
Q

Linguistic skills

A
  • Anomia: failure to name objectscommon first symptom of AD
  • Intrusions (inserting inappropriate words)
  • Perseverations (repeating same word)
  • Circumlocution (talking around subject)
  • Phonology and morphology well preserved
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13
Q

Visuo-spatial skills

A
  • Decline in early stage of AD
  • Closing-in: drawing something which is supposed to be copied on or close to the target
  • Clock-drawing test (CDT)
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14
Q

Olfaction

A
  • Worsens

* Poorer memory for smells

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15
Q

The effect on caregivers

A

• Depression, suicide risk, elder abuse

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16
Q

A person-centered approach

A 
•	D=P+B+H+NI+SP
D= demented patient as they present themselves
P=personality
B=life experience
H=physical health
NI=neurological impairment
SP=social psychology
•	Malignant social psychology: surrounding is intimidating, no sense of personal identity
•	Dementia care mapping
17
Q

Dementia- a summary

A

• Progressive loss of memory, intellectual skill and linguistic skills

18
Q

Learning disabilities

A
  • Older with learning disabilities: higher levels of depression and anxiety
  • Higher risk of dementia
19
Q

Depression

A
  • Far less common in later life

* Except: institutionalized patients, dementia patients

20
Q

Anxiety

A
  • 10% of elders have anxiety disorder, majority phobia
  • Agoraphobia very common
  • A little anxiety can be useful
21
Q

Substance abuse

A
  • Risk of gambling
  • Heavy consumers of hypnotic and sedative (sleep inducing) drugs
  • 11% of old Americans abuse drugs
  • Neuroleptic drugs often prescribed wrongly
  • Old drug-addicts numbers will increase with baby boomers
  • Not as much heavy drinkers in older generations but also cohort effects
  • 5% of old Americans living independently have alcohol problemmeasuring problems
  • Men more likely to have drinking problem than women
  • Alcohol consumption can be beneficial
  • Alcohol abuse in old lowest for any age group
22
Q

Personality disorder

A
  • Lower chance of getting diagnosed
  • Most common: dependent and avoidant
  • Numbers might be higher
  • Cofounded with depression and self-harm
  • Cultural differences
23
Q

Schizophrenia

A
  • Early onset schizophrenia (EOS)

* Late onset schizophrenia (LOS) ¼ of cases

24
Q

Overview

A

• Mental illness in older patients lower than for population as a whole

Geropsychology (19 decks)

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