Disorders Of Aging Flashcards
Delerium
Acute; usually reversible. Extremely common in hospitalized. Major characteristics: changes in consciousness. Perceptual disturbances. Dramatic mood swings. Risk for self-harm.
Causes of delirium
Intoxication or withdrawal.
Metabolic disorders.
Medications
Infections
Dementia
Gradual onset; usually permanent. Not a normal part of growing older. De- without mentia- mind
Causes of dementia
Alzheimer's disease Vascular dementia Dementia with Lewy bodies Mixed dementia Parkinson's disease dementia Frontotemporal dementia Creutzfeldt-Jakob dementia Normal pressure hydrocephalus Huntington's disease Wernicke-Korsakoff syndrome Brain trauma
Alzheimer’s disease
A primary cognitive impairment disorder characterized by progressive deterioration of cognitive functioning, with the end result that the person may not recognize once familiar people, places and things. The ability to walk and talk is absent in the final stages.
Risk factors for Alzheimer’s
Age Family history (10-30% increase) Inheritance of E4/E4 alleles ApoE Mild cognitive impairment (MCI) Atherosclerosis risk factors Head injury (concussion) Decreased social, mental, & physical activity History of depression Hormone replacement therapy
Alzheimer’s Disease Stage 1: Mild
Decreased initiative, interests, energy
Slight memory loss (short-term)
Depression common.
Faulty judgment
Alzheimer’s Disease Stage 2: Moderate
Memory loss interferes with functioning
Decrease in “instrument” ADLs
Mood disturbances
Require extensive care/supervision
Alzheimer’s Disease Stage 3: moderate to severe
Wandering Loss of ADLs Increasing loss of language skills Depression resolves Skilled care facility often necessary
Alzheimer’s Disease Stage 4: late
Family and self recognition lost Mute; may scream Nonambulatory Forgets how to eat Seizures
Aricept (donepezil)
FDA indications: mild to severe AD
S/E: Nausea, diarrhea, insomnia, fatigue
*best one to give. S/E not as severe. Once a day. Generic.
Razadyne (galantamine)
Indications: mild to moderate AD
S/E: nausea, vomiting, diarrhea
Exelon (rivastigmine)
Indications: mild to moderate AD, Dementia of PD
S/E: nausea, vomiting, weight loss, syncope
*second worst S/E
Exelon transdermal
Indications: mild to moderate AD
S/E: nausea, dizziness, and drowsiness
Cognex (tacrine)
Indications: mild to moderate AD
S/E: liver damage!!!
don’t give anymore
Namenda (memantine)
NMDA receptor antagonist
Moderate to severe AD
Common S/E: dizziness, sedation, transient confusion
Antipsychotics for AD
Agitation, aggression, delusions, hallucinations frequently occur in AD.
Both classes of antipsychotics now carry a black-box warning: increased risk of death in elderly patients
May still be prescribed
Agnosia
Loss of the ability to recognize familiar objects.
Agraphia
Loss of a previous ability to write, resulting from brain injury or brain disease.
Aphasia
Difficulty in the formulation of words; loss of language ability. In extreme cases, a person may be limited to a few words, may babble, or may become mute.
Apraxia
Loss of the ability to perform purposeful movements. For example the person may be unable to shave, dress or to perform other once familiar and purposeful tasks.
Cognitive disorders
Psychiatric disorders that are manifested in deficits in memory, perception, and problem solving.
Confabulation
The filling of a memory gap with a detailed fantasy believed by the teller. The purpose is to maintain self-esteem. It is seen in organic conditions such as Korsakoff’s psychosis.
Hypermetamorphosis
The desire to touch everything in sight
Hyperorality
The desire to taste everything, chew everything, and to put everything in one’s mouth.
Hypervigilance
A state of extraordinary alertness
Perseveration
The involuntary repetition of the same thought, phrase, or motor response. It is associated with brain damage.
Primary dementia
Dementia that is irreversible, progressive, and not secondary to any other disorder
Pseudodementia
A disorder that mimics dementia
Secondary dementia
Dementia that is due to an underlying disease process, such as metabolic, nutritional, or neurological disorder.
Sundowning
Increasing destabilization of cognitive abilities and lability of mood during the late afternoon, early evening, or night. Seen in people with cognitive disorders.
