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Aging > cognitive and behavioral changes > Flashcards

cognitive and behavioral changes Flashcards

1
Q

geriatric assessment

A
  1. medical
  2. functional: physical (ambulation - ADLs), cognitive
  3. psychosocial: caregiver
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2
Q

dementia risk factors

A
  • age
  • affects females more
  • down’s syndrome
  • genetic: AD gene mutations (amyloid precursor protein). e4 allele: increases risk of dementia
  • family history

dementia pathology:
Medial temporal lobe atrophy/
Amyloid plaques develop in the hippocampus

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3
Q

modifiable risk factors for dementia

A
  • cognitive reserve: capacity beyond what is needed for daily functioning, to be able to be more resilient or adaptive to brain pathology
    brain plasticity - use-dependent - use brain more to reduce risk
  • diabetes
  • HTN
  • head injury
  • smoking
  • air pollution
  • midlife obesity
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4
Q

reduce risk of dementia

A 
frequent exercise
reduce occurrence of depression
avoid alcohol
social contact
education
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5
Q

dementia definition

A

decline in memory and cognitive domains, affecting daily fn

progressive and disabling

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6
Q

reversible causes of dementia

A 
D - drugs (anti-cholinergics/H2 blockers/ benzodiazepines)
E - emotion (depression)
M - metabolism (hypothyroidism, hypercalcemia)
E - eyes/ears (sensory isolation)
N - normal ICP pressure (hydrocephalus)
T - tumour/space occupying lesion
I - infection (syphilis/HIV)
A - anemia/alcohol
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7
Q

irreversible causes of dementia

A

alzhiemer’s disease

vascular dementia: stepwise decline, focal signs

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8
Q

alzhiemers disease

A

symptoms: 4As (amnesia, apraxia, aphasia, agnosia - loss of sensory)
imaging signs: medial temporal lobe atrophy, small hippocampus
formation of amyloid plaques

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9
Q

clinical features of dementia

A

(ABC)
Activities: loss of independence for daily activities
Behavioral changes
Cognitive: memory deficit - esp for new things
disorientation/impaired judgement

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10
Q

depression definition

A

mental disorder characterised by low mood, loss of interest.
present w/ affective, physical and cognitive symptoms
can become chronic -> substantial impairments in one’s ability to take care of everyday responsibilities

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11
Q

mechanism of depression

A

decrease neurotransmitters: serotonin, norepinephrine, dopamine

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12
Q

risk factors for depression

A
  • biological: family/past history
  • social: isolation, loss of kin/job
  • physical: chronic pain, diseases (cancer/CVA), beta blockers
  • psychological: dementia, anxiety
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13
Q

features of depression

A

(ABC)
Affective: low mood, loss of interest
Behavioral: agitation, fatigue, altered appetite
Cognitive: poor memory and decision making

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14
Q

under-treated depression

A

decreased QOL
caregiver stress
suicide

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15
Q

delirium definition

A

non-specific neuropsychiatric manifestation of a generalised disorder of cerebral metabolism and neurotransmission

  • acute confusional state
  • altered mental state
  • organic brain syndrome
  • toxic/metabolic encephalopathy
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16
Q

delirium characteristics

A

high vulnerability, small insult
low vulnerability, high insult

  • means a fit person not likely to get delirium -> if he appears with delirium probably means that there is a major insult somewhere - find out what!
17
Q

delirium mordibity

A

high morbidity
poor recovery
increase risk of death following discharge

18
Q

causes of delirium

A 
D: drugs
E: eyes/ears
L: low O2 states (AMI, stroke, GI bleed)
I: infection
R: retention (urine/poop)
I: ictal (seizure/stroke/headache)
U: underhydration/ nutrition
M: metabolic 
S: subdural hemorrhage (esp in elderly w/ shrunken brain)
19
Q

delirium diagnosis (confusion assessment method**)

A

acute change/fluctuation in mental status or
inattention

and
disorganised thinking
altered level of consciousness

20
Q

delirium vs dementia vs depression

A

delirium: acute onset, fluctuating, clouded disorientation, poor STM w/ inattention, psychosis
dementia: gradual onset, steadily progressive, poor STM w/o marked inattention
depression: variable onset, usually diurnal (daytime), does not affect consciousness, poor attention but memory intact

STM = short term memory

Aging (9 decks)

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