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module 4 abnormal > chp 15 > Flashcards

chp 15 Flashcards

1
Q

Old age is usually defined in our society as the years past age
Like childhood, old age brings special

A
  • Old age is usually defined in our society as the years past age 65
  • Approximately 46 million people in the United States are “old”—14.5 percent of the population and growing
  • Older women outnumber older men by 3 to 2
  • Like childhood, old age brings special pressures, unique upsets, and profound biological changes
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2
Q

• The psychological problems of elderly persons may be divided into two groups:

A
  • Disorders that may be common in people of all ages but are connected to the process of aging
  • Depressive, anxiety, and substance use disorders
  • Disorders of cognition that result from brain abnormalities
  • Delirium, mild neurocognitive disorders, and major neurocognitive disorders
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3
Q

DEPRESSION IN LATER LIFe

  • Depression is one of the ____ ____ mental health problems of older adults
  • features are the ___ for elderly people as for younger people
  • higher rate in what gender
  • raises chances of developing ____ problems
A
  • Depression is one of the most common mental health problems of older adults
  • The features of depression are the same for elderly people as for younger people
  • As many as 20 percent of people experience this disorder at some point during old age
  • The rate is highest in older women
  • Studies suggest that depression among older people raises their chances of developing significant medical problems
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4
Q

treatment effectiveness

  • More than _____of older patients with depression improve with these treatments
  • It is sometimes _____ for elderly people to use antidepressant drugs effectively and safely because the body’s ________works differently in later life
  • Among elderly people, antidepressant drugs have a higher risk of causing some _______ impairment
A
  • More than half of older patients with depression improve with these treatments
  • It is sometimes difficult for elderly people to use antidepressant drugs effectively and safely because the body’s metabolism works differently in later life
  • Among elderly people, antidepressant drugs have a higher risk of causing some cognitive impairment
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5
Q

ANXIETY DISORDERS IN LATER LIFE
-anxiety is _____ among the elderly
-The prevalence of anxiety _____throughout old age
-Many things about aging may_____ anxiety levels, including declining health
-Researchers have ____ systematically tied anxiety disorders among the elderly to specific events or losses
Such drugs must be used _____ in older people

A

• Anxiety is common among the elderly
• At any given time, approximately 11 percent of elderly men and women in the United
States experience at least one of the anxiety disorders
• GAD is particularly common, experienced by up to 7 percent of all elderly persons
• The prevalence of anxiety increases throughout old age
• Many things about aging may heighten anxiety levels, including declining health
• Researchers have not systematically tied anxiety disorders among the elderly to specific
events or losses
• Older adults with anxiety disorders are often treated with psychotherapy of various kinds, particularly cognitive-behavioral therapy
• Many receive antianxiety medications
• Such drugs must be used cautiously in older people

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6
Q

SUBSTANCE MISUSE IN LATER LIFE
-Although alcohol abuse and other forms of substance abuse are significant problems for many older persons, the prevalence of such patterns appears to decline after age
-Accurate data about rates of substance abuse among older adults are______ to obtain because many elderly persons do not suspect or admit they have such a problem
-Researchers often distinguish between
The latter group typically begins abusive drinking as a reaction to the

A
  • Although alcohol abuse and other forms of substance abuse are significant problems for many older persons, the prevalence of such patterns appears to decline after age 60
  • Accurate data about rates of substance abuse among older adults are difficult to obtain because many elderly persons do not suspect or admit they have such a problem
  • Approximately 3–7 percent of older people, particularly men, display alcohol-related disorders in a given year
  • Researchers often distinguish between older problem drinkers who have experienced significant alcohol-related problems for many years and those who do not start the pattern until their 50s and 60s
  • The latter group typically begins abusive drinking as a reaction to the negative events and pressures of growing older
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7
Q

A leading kind of substance abuse in the elderly is misuse of
-Another drug-related problem is the misuse of powerful medications at

A

prescription drugs
• Most often it is unintentional
Another drug-related problem is the misuse of powerful medications at nursing homes

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8
Q

PSYCHOTIC DISORDERS IN LATER LIFE
- Elderly people have a_____ rate of psychotic symptoms than younger persons
- Among elderly people, these symptoms are usually due to underlying medical conditions such as ____ and _____
However, some elderly persons suffer from ______ or ______ disorders
-• Schizophrenia is ___common in older persons than in younger ones

A
  • Elderly people have a higher rate of psychotic symptoms than younger persons
  • Among elderly people, these symptoms are usually due to underlying medical conditions such as delirium and dementia
  • However, some elderly persons suffer from schizophrenia or delusional disorders
  • Schizophrenia is less common in older persons than in younger ones
  • Many people with schizophrenia find that their symptoms lessen in later life
  • It is uncommon for new cases of schizophrenia to emerge in later life
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9
Q

• In delusional disorders, individuals develop beliefs that are____ but not bizarre
-this disorder is____ in most age groups, but its prevalence appears to increase in the elderly population
• Some clinicians suggest that the increased rate is related to the

A

false
• This disorder is rare in most age groups, but its prevalence appears to increase in the elderly population
• Some clinicians suggest that the increased rate is related to the deficiencies in hearing, social isolation, greater stress, or heightened poverty experienced by many elderly persons

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10
Q

DISORDERS OF COGNITION
-While problems in memory and related cognitive processes can occur without biological causes (in the form of dissociative disorders), more often cognitive problems have
• Leading cognitive disorders among the elderly:

A
  • While problems in memory and related cognitive processes can occur without biological causes (in the form of dissociative disorders), more often cognitive problems have organic roots, particularly when they appear in later life
  • Leading cognitive disorders among the elderly:
  • Delirium
  • Major neurocognitive disorder
  • Mild neurocognitive disorder
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11
Q

DELIRIUM:
-leads to
what causes it
-more prevalent in who

A

• Delirium: A clouding of consciousness
• As a person’s awareness of the environment becomes less clear, the individual has great
difficulty concentrating, focusing attention, and thinking sequentially
• This leads to misinterpretations, illusions, and, on occasion, hallucinations
• This state of massive confusion typically occurs over a short period of time, usually hours or days
• It may occur in any age group, including children, but is most common in elderly persons
• Delirium affects fewer than 0.5 percent of the nonelderly population, 1 percent of people older
than 55, and 14 percent of those older than 85
• Fever, certain diseases and infections, poor nutrition, head injuries, strokes, stress (including the trauma of surgery), and intoxication by certain substances may all cause delirium

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12
Q

neurocognitive disorder

  • decline in
  • may also experience changes in
A
  • People with neurocognitive disorder experience a significant decline in at least one (often more than one) area of cognitive functioning, such as memory, attention, visual perception, planning and decision making, language ability, or social awareness
  • People may also experience changes in personality and behavior
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13
Q

Major and mild neurocognitive disorders
A neurocognitive disorder in which the decline in cognitive functioning is _______and______ with a person’s ability to be independent

A
  • Major neurocognitive disorder: A neurocognitive disorder in which the decline in cognitive functioning is substantial and interferes with a person’s ability to be independent
  • Mild neurocognitive disorder: A neurocognitive disorder in which the decline in cognitive functioning is modest and does not interfere with a person’s ability to be independent
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14
Q

The experience of neurocognitive disorder is closely related to
increases as you get
result from what kind of correctable problems
most forms are caused by

A
  • The experience of neurocognitive disorder is closely related to age
  • Among people 65 years of age, prevalence is 1–2 percent
  • Among those older than age 85, prevalence increases to as much as 50 percent
  • Some forms of this deterioration result from nutritional, metabolic, or other correctable problems
  • Most forms are caused by brain disease or injury, such as Alzheimer’s disease or stroke, which are currently difficult or impossible to correct
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15
Q

Alzheimers is the most

  • most often occurs after the age of
  • time between onset and death is
  • onset begins with mild
A

• Alzheimer’s disease, identified in 1907, is the most common form of neurocognitive disorder, accounting for as many as two-thirds of all cases
• Approximately 5 million people in the United States currently have this disease
• This gradually progressive disease sometimes appears in middle age (early onset), but
most often occurs after the age of 65 (late onset)
• Its prevalence increases markedly among people in their late 70s and early 80s
• The time between onset and death is typically 8–10 years, although some people may survive for as many as 20 years
• Onset usually begins with mild memory problems, lapses of attention, and difficulties in language and communication

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16
Q

as symptoms worsen

  • As symptoms worsen, the person has trouble completing
  • Eventually individuals have difficulty with simple
  • As the symptoms of dementia intensify, people show less
  • Eventually they become fully
  • Patients with Alzheimer’s disease usually remain in good health until
A

• As symptoms worsen, the person has trouble completing complicated tasks and remembering important appointments
• Eventually individuals have difficulty with simple tasks, distant memories are forgotten, and changes in personality often become very noticeable
• As the symptoms of dementia intensify, people show less awareness of their limitations
• Eventually they become fully dependent on other people, lose almost all knowledge of the
past, and fail to recognize the faces of even close relatives
• Patients with Alzheimer’s disease usually remain in good health until the later stages of the disease

17
Q
  • Alzheimer’s disease can be diagnosed with certainty only after
  • senile plaques
  • neurofibrillary tangles
A
  • Alzheimer’s disease can be diagnosed with certainty only after death, when structural changes in the brain can be fully examined
  • Senile plaques: Sphere-shaped deposits of beta-amyloid protein that form in the spaces between cells in the hippocampus, cerebral cortex, and certain other brain regions and blood vessels
  • Neurofibrillary tangles: Twisted protein fibers found within the cells of the hippocampus
18
Q

WHAT ARE THE GENETIC CAUSES OF ALZHEIMER’S DISEASE?
-Alzheimer’s disease often has a genetic
-Clinicians now distinguish between familial
sporadic

A
  • Alzheimer’s disease often has a genetic basis
  • Clinicians now distinguish between early-onset (familial) Alzheimer’s disease and late-onset (sporadic) Alzheimer’s disease
19
Q

HOW DOES BRAIN STRUCTURE RELATE TO ALZHEIMER’S DISEASE?
• The human brain has two memory systems that work together to help us learn and recall
-what gathers new info
must be transformed into
-what is the accumulation of Information over years

A

• The human brain has two memory systems that work together to help us learn and recall
• Videos are available in BB
• Short-term memory, or working memory, gathers new information
• Information held in short-term memory must be transformed, or consolidated, into long-term memory if
we are to hold on to it
• Long-term memory is the accumulation of information that we have stored over the years
• Remembering information stored in long-term memory is called retrieval

20
Q

• Certain brain structures seem to be especially important in memory

A

• Prefrontal lobes: Appear to hold information temporarily and to continue working
with the information as long as it is needed
• Temporal lobes and diencephalon: Seem to help transform short-term memory into long-term memory
• Research indicates that cases of dementia involve damage to or improper functioning of one or more of these areas

21
Q

WHICH BIOCHEMICAL CHANGES IN THE BRAIN RELATE TO ALZHEIMER’S DISEASE?

  • biochemical changes that occur in cells as
  • Several chemicals are responsible for the production of proteins in key cells when new
  • If the activity of these chemicals is disturbed, the proper production of proteins may be prevented and the formation of memories
  • Some research suggests that abnormal activity by these chemicals may contribute to the symptoms of
A
  • Memory researchers have identified biochemical changes that occur in cells as memories form
  • Several chemicals are responsible for the production of proteins in key cells when new information is acquired and stored
  • If the activity of these chemicals is disturbed, the proper production of proteins may be prevented and the formation of memories interrupted
  • Some research suggests that abnormal activity by these chemicals may contribute to the symptoms of Alzheimer’s disease
22
Q

OTHER EXPLANATIONS OF ALZHEIMER’S DISEASE

  • substances found in nature
  • autoimmune theory
  • viral theory
  • Creutzfeldt-Jakob disease
  • To date, no such
A

• Other possible explanations for development of Alzheimer’s disease:
• Certain substances found in nature, including zinc, may produce brain toxicity, which may
contribute to the development of the disease
• The environmental toxin lead may contribute to the development of Alzheimer’s disease
• Autoimmune theory
• Changes in aging brain cells may trigger an autoimmune response, leading to the disease
• Viral theory
• Because Alzheimer’s disease resembles Creutzfeldt-Jakob disease (a form of dementia caused
by a virus), some researchers propose that a similar virus may cause Alzheimer’s disease
• To date, no such virus has been detected in the brains of patients with Alzheimer’s disease

23
Q 
•
OTHER TYPES OF NEUROCOGNITIVE DISORDERS
Vascular neurocognitive disorder
-blood flow is \_\_\_ to areas of brain
Pick’s disease
-rare \_\_\_affects what sections of the brain

Creutzfeldt-Jakob disease:
-symptoms include

A

-Vascular neurocognitive disorder
• May follow a cerebrovascular accident, or stroke, during which blood flow to specific areas of the brain was cut off, with resultant damage
• This disorder is progressive but its symptoms begin suddenly, rather than gradually
• Cognitive functioning may continue to be normal in the areas of the brain not affected by the stroke

Pick’s disease: Frontotemporal neurocognitive disorder
• A rare disorder that affects the frontal and temporal lobes
• Clinically similar to Alzheimer’s disease

Creutzfeldt-Jakob disease: Neurocognitive disorder due to prion disease
• Caused by a slow-acting virus
• Symptoms include spasms of the body

24
Q

huntingtons disease

parkinsons disease

A
  • Huntington’s disease: An inherited progressive disease in which memory problems worsen over time, along with personality changes, mood difficulties, and movement problems
  • Parkinson’s disease: A slowly progressive neurological disorder marked by tremors, rigidity, and unsteadiness that can cause dementia
25
Q

• A number of other disorders may lead to neurocognitive disorders:

A

• Viral and bacterial infectious disorders such as HIV and AIDS, meningitis, and
advanced syphilis
• Brain seizure disorder
• Drug abuse

26
Q

WHICH TREATMENTS ARE CURRENTLY AVAILABLE?

which is most helpful

A
  • Treatments for the cognitive features of Alzheimer’s disease have been at best modestly helpful
  • A number of approaches have been applied, including drug therapy, cognitive techniques, behavioral interventions, support for caregivers, and sociocultural approaches
27
Q

• Alternative drug treatments are being investigated

  • Studies suggest that certain substances reduce the risk of Alzheimer’s disease
  • Cognitive-behavioral strategies that focus primarily on
  • _____is often part of a treatment program
  • _______ocused interventions of a different kind have been used to help improve specific symptoms displayed by patients with Alzheimer’s disease
A

• Studies suggest that certain substances (e.g., Naprosyn, ibuprofen) may
reduce the risk of Alzheimer’s disease
• Research results have been mixed
• Cognitive-behavioral strategies that focus primarily on behaviors rather than on cognitions seem to be even more useful in preventing and managing this disease
• Physical exercise is often part of a treatment program
• Behavior-focused interventions of a different kind have been used to help improve specific symptoms displayed by patients with Alzheimer’s disease

28
Q

• Caregiving can take a heavy toll on the close relatives of people with dementia
-One of the most frequent reasons for the institutionalization of people with Alzheimer’s disease is that overwhelmed caregivers can no longer

A
  • Almost 90 percent of all people with dementia are cared for by their relatives
  • One of the most frequent reasons for the institutionalization of people with Alzheimer’s disease is that overwhelmed caregivers can no longer cope with the difficulties of keeping them at home
29
Q

ISSUES AFFECTING THE MENTAL HEALTH OF THE ELDERLY

As the study and treatment of elderly people have progressed, three issues have raised concern among clinicians:

A
  • As the study and treatment of elderly people have progressed, three issues have raised concern among clinicians:
  • The problems faced by elderly members of racial and ethnic minority groups
  • The inadequacies of long-term care
  • The need for a health-maintenance approach to medical care in an aging world
30
Q

CLINICIANS DISCOVER THE ELDERLY

- particularly urgent issue is

A
  • Current work is changing how we understand and treat the psychological problems of the elderly
  • As the elderly population lives longer and grows ever larger, the needs of people in this age group are becoming more visible
  • A particularly urgent issue is neurocognitive impairment and its devastating impact on the elderly and their families
  • The complexity of the brain makes neurocognitive disorders difficult to understand, diagnose, and treat, but researchers are now making important discoveries on a regular basis

module 4 abnormal (4 decks)

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