Exam 4: Disorders of Aging Flashcards
what age is considered old
past 65
-12% of the population is old
psychological problems of elderly are divided into what 2 groups?
- disorders that may be common in people of all ages but are connected to the process of aging (depression, anxiety, substance use disorders)
- disorders of cognition that result from brain abnormalities (delirium, neurocognitive disorders)
depression in later life
- one of the most common mental health problems in older adults
- elderly more likely to die by suicide than younger persons
depression is linked to
- loss of social network; loss of social function
- loss of cognitive/physical abilities
- physical health disorders
- differential diagnosis is difficult (depression vs. early-stage alzheimers)
- pharmacological treatments are more complicated
anxiety disorders later in life
- generalized anxiety disorder experienced by up to 7% of all elderly people
- differential diagnosis from cognitive disorders is difficult
- pharmacological treatments more complicated
- depression & anxiety may contribute to misuse of alcohol/other substances
- overall prevalence rates decline, but some individuals initiate substance misuse in 50s/60s to self-medicate
- growing problem is misuse of prescription meds
normal changes vs. disorders of cognition
- cognitive mishaps (leaving w/out keys, forgetting someones name) are a common & normal feature of stress/aging
- as people move through middle age, these memory difficulties and lapses of attention increase & they may occur regularly by age 60/70
common (normal) changes associated w/ aging include increased challenges in:
- mastering new info/skills
- retrieval of info such as names, instructions, directions
- multitasking
delirium
- a major disturbance in attention and orientation to environment
- difficulty concentrating/thinking in an organized way
- leads to misinterpretations, illusions and, less frequently, hallucinations
- this state of massive confusion typically develops over a short period of time, usually hours or days
what can cause delirium
- fever, certain diseases and infections, poor nutrition, head injuries, strokes, stress (including the trauma of surgery)
- may resolve w/ treatment or over time
neurocognitive disorders (including alzheimers disease)
- significant decline in at least one area of cognitive functioning such as:
- memory & learning, attention, planning, decision making, language ability or social awareness, changes in personality/behavior
- among people 65 years of age, the prevalence is around 1-2% (increases to as much as 50% among those over the age of 85
encephalitis
-viral infection resulting in inflammation of the brain causing dramatic memory impairments
what is the most common type of neurocognitive disorder?
- alzheimer’s disease
- accounts for as many as 2/3 of all cases
- time between onset and death is typically 8-10 years (some may survive 20 yrs)
- usually begins w/ mild memory problems, lapses of attention, difficulties in language & communication
alzheimer’s disease
- as symptoms worsen, the person has trouble completing complicated tasks
- eventually sufferers have difficulty w/ simple tasks, distant memories are forgotten, changes in personality often become very noticeable
- they ultimately become fully dependent on others, lose almost all knowledge of past, fail to recognize faces of even close relatives
symptoms that may indicate dementia
- difficulty performing simple tasks; forgetting how to do things done many times
- unable to recall/describe specific instances where memory loss caused problems
- gets lost/disoriented in familiar places; unable to follow directions
- words are forgotten, misused, garbled; repeats phrases/stories in same conversation
- trouble making choices; may show poor judgement or behave socially inappropriately
senile plaques
deposits of beta-amyloid protein in the spaces between cells in the hippocampus, cerebral cortex, and brain regions
-alzheimers diagnosis can be confirmed only by post-mortem findings of changes in brain
neurofibrillary tangles
twisted protein fibers found w/in the cells of hippocampus
-alzheimers diagnosis can be confirmed only by post-mortem findings of changes in
how does brain structure relate to alzheimers disease?
-hippocampus: large neurons shrink/die. Amyloid deposits develop in spaces between cells. Neurofibrillary tangles develop w/in neurons
what two memory systems work together to help us learn & recall?
- short-term (working) memory gathers new info
- long-term memory is the accumulation of info that we have stored over the years
- alzheimers disease may involve damage/improper functioning on one or more of these structures
short-term memory
- gathers new info
- working memory
- prefrontal lobes hold info temporarily
- info in short-term memory must be consolidated into long-term memory (role of hippocampus)
long-term memory
accumulation of info that we have stored over the years
other explanations of alzheimers disease
- certain substances found in nature, including zinc, may produce brain toxicity contributing to the disease
- the environmental toxin lead may contribute
- changes in aging brain cells may trigger an autoimmune response, leading to the disease
treatment of alzheimers disease
- family support that includes psychoeducation & restructuring of the persons environment
- caregiving takes a heavy toll on the close relatives of people w/ alzheimers
- 90% of people w/ alzheimers disease are cared for by their relatives
- the most common reason for institutionalization of persons w/ alzheimers is that caregivers can no longer manage their behavior at home
treatment of alzheimers disease (2)
- meds may slow/delay cognitive decline & manage anxiety and behavior dysregulation (e.g. aricipt (donepeil), Razadyne (galantamine)
- cognitive reserve may initially delay or mask symptoms of alzheimers
behavioral care centers as treatment for alzheimers
- day-care and assisted living facilities - including short-term respite-units - may provide care for persons w/ Alzheimers disease
- such facilities may help slow the cognitive decline of residents and enhance their enjoyment of life
- supportive medical care may be required during final stages
picks disease
a rare disorder that affects the frontal and temporal lobes and is clinically similar to alzheimers disease
Creutzfeldt-Jakob disease
caused by a virus and results in cognitive and physical decline (mad cow disease - from eating nerve tissue (brain, spinal cord) of infected cattle)
huntingtons disease
an inherited progressive disease in which memory problems worsen over time, along w/ personality changes, mood difficulties, and movement problems
parkinsons disease
a slowly progressive neurological disorder marked by tremors, rigidity, and unsteadiness that may also cause neurocognitive decline
- can involve neuromuscular impairment w/out neurocognitive decline
- surgical intervention (deep brain stimulation) following reduced response to levodopa
what does each system control:
- frontal lobe
- motor (cortex)
- cerebellum
- brain stem
- limbic system
- frontal lobe: planning
- motor/cortex: sensory
- cerebellum: coordinates movement
- brain stem: body basics
- limbic system: hypothalamus, amygdala (emotions), hippocampus (memory)
