Cognition and Aging Flashcards
Week 5 - Depression, Delirium, Dementia
What is cognition?
complex series of function
regulate behaviors/actions
content of thoughts
system for information processing
what we pay attention to and take in
What are the 6 domains of cognition?
Learning & memory, language, complex attention, executive function, perceptual-motor function, social cognition.
What are the 3 main factors that affect cognition?
Aging, disease, disuse.
What are key PT implications for age-related cognitive changes?
(memory changes)
Use sensory cues, eliminate distractions, incorporate repetitive practice
(complex attention)
optimize the learning environment.
What are age “associated” dysfunctions?
Depression
Delirium
Dementia
Is depression a normal consequence of aging?
No, depression is not a normal part of aging.
What percentage of community-dwelling individuals over 65 have clinical depression?
5%, but it increases with hospitalization and dependence.
How does depression impact rehab outcomes?
Leads to longer hospital stays, reduced functional recovery, and higher healthcare costs.
**can mimic cognitive impairments
What are some signs/symptoms of depression?
depressed mood
lack of pleasure
weight gain/loss >5% in one month
What does masked depression primarily present with?
physical symptoms
pain, weakness, dizziness, SOB
What are common treatment approaches for depression?
SSRIs, TCAs, CBT, and exercise.
What are some outcome measures we can use to screen for depression in older adults?
2 question test
Beck Depression Inventory
CES-D (primarily for caregivers)
GDS
What is delirium?
A sudden, rapid change in mental status with fluctuating symptoms.
What are the three types of delirium?
Hypoactive
Hyperactive
Mixed
What are key risk factors for delirium?
Age, multiple comorbidities, metabolic disorders, infections, electrolyte imbalances, medications, anesthesia, trauma.
How does Hyperactive Delirium present?
yelling, falls, agitation
rapid mood swings, hallucinations
most often treated
How does Hypoactive Delirium present?
confusion
appears sluggish, lethargic, quiet
not treated due to symptoms being less apparent and misdiagnosed as dementia
What are key delirium prevention strategies?
Nutrition/hydration, early mobilization, avoiding certain anesthetics and restraints, behavioral interventions, sensory support.
Is dementia a disease?
No, it is a clinical syndrome of cognitive and functional decline.
With dementia, what is there a loss of cognitively/functionally?
memory
intellect
rational thought
social skills
emotional reactions/regulation
What are the 4 main diseases affecting cognition?
Alzheimer’s, vascular dementia, Lewy body dementia, frontotemporal dementia.
What is the main pathological hallmark of Alzheimer’s disease?
Amyloid plaques and neurofibrillary tangles leading to inflammation and neuronal destruction
progressive and irreversible
What are the four associated features of dementia?
spatial disorientation
poor judgement and insight
gait disturbances
disinhibited behavior
What are the 3 recommended screening tools for dementia?
Mini-cog
General practitioner assessment of cognition
memory impairment screening
What are the stages of dementia based on MMSE scores?
Normal: 24-30
Mild: 19-24, IADLs impacted
Moderate: 9-18, ADLs impacted, needs assistance
Severe: 0-8, dependent for ADLs.
What is the biggest mobility-related risk for people with dementia?
They are twice as likely to fall compared to those without dementia.
What are common gait changes seen in dementia?
Slower walking speed, cautious gait, difficulty in unfamiliar environments.
What is a compensatory strategy for dementia patients in PT?
Focus on fall prevention, environmental modifications, caregiver training, and maintaining functional abilities.
What kind of exercise is beneficial for dementia patients?
Functional or activity-based, multimodal (e.g., dual-task training).
What is the ‘reserve hypothesis’?
Older adults can improve their memory with regular cognitive exercise
“use it or lose it” theory
