Geriatrics

Question 1

What is pseudodementia?

Answer 1

the presence of apparent cognitive deficits in patients, most commonly the elderly, with major depression

Question 2

What are some factors that can help differentiate pseudodementia from true dementia?

Answer 2

sundowning, confabulation, and poor insight are more common in those with dementia whereas those with pseudodementia are less likely to have sundowning, more likely to just say “I don’t know”, and more likely to be aware of problems

Question 3

What are the five stages of grief?

Answer 3

• denial
• anger
• bargaining
• depression
• acceptance

Question 4

Describe normal grief.

Answer 4

symptoms may include intense feelings of guilt or sadness, sleep disturbances, appetite changes, and illusions; however, these typically abate within 6 months of the loss and don’t impact the patient’s ability to function appropriately in their life

Question 5

Which demographic has the highest rate of successful suicide attempts?

Answer 5

older, white males

Question 6

What are four non-pharmacological treatments available for behavioral symptoms in the elderly?

Answer 6

• music, art, exercise, or pet therapy
• strict daily schedules with continual reorientation of the patient
• reduction of stimuli
• surround patient with familiar objects

Question 7

If a patients has dementia and has visual hallucinations early in the course, what does this suggest? How does this impact pharmacological management?

Answer 7

• it is suggestive of dementia with Lewy bodies

- these patients should not receive antipsychotics

Question 8

What normal changes in sleep are associated with aging?

Answer 8

• a decrease in REM latency and in total REM
• a decrease in slow wave sleep
• less total sleep, with more frequent awakenings
• sleep cycle advancement (earlier to bed, earlier to rise)