Gerontics Test 2 Flashcards
Use of non pharmacological therapies to manage the dementia process, appropriate use of available medications
Active management
Impairments for diagnosis of dementia
Memory impairment, aphasia (language impairment), apraxia (motor planning impairment), agnosia (inability to recognize people and things), and/or loss of executive function
AD + vascular disease (other dementing disorder)
Mixed dementia
Acute and fluctuating change in cognition and function, must be ruled out to make diagnosis of dementia
delirium
Areas of brain affected in AD?
hippocampus, medial temporal lobe, parietal lobe
__________ can present itself after an acute vascular accident (stroke)
Vascular dementia (VaD)
Dementia with __________ results from the development of accumulations of alpha-synuclein proteins within nerve cells of in the cortex and substantia nigraof midbrain, protein also linked with Parkinson’s disease, shared symptoms of AD and Parkinson’s disease dementia
Lewy Bodies
Represents a complex group of degenerative disorders that primarily affect the frontal and anterior temporal lobes of the brain
Frontotemporal dementia
Affected lobes in frontotemporal dementia responsible for what?
reasoning, personality, movement, speech, social grace, language
What is important in all stages of dementia?
Promoting independence
Normal functioning, absence of cognitive functional disability, relevant info from memory stores can be activated and used to carry out complex activity with accuracy and safety
5.6
Mild functional decline due to deficits in executive control functions (task planning, problem solving, divided attention, new learning), difficulties may manifest in the performance of IADLs. Check- in support and assistance with IADLs may be needed but there is no change in ADLs
5.0
Mild to moderate functional decline due to significant deficit in executive control functions, difficulty with divided attention and problem solving. Complex tasks performed with inconsistency or error. Problem with details in IADLs, decline in ability to self-initiate ADLs. Risk in independent living (managing meals, finances, medications), Driving dangerous due to impaired attention and lack of environmental cues, family crisis point, assisted living is a good fit
4.5
Moderate functional decline from abstract to concrete thought processes, person relies on familiar routines and environments, IADLS done with or by others, quality of ADLs declines, not safe to live alone
4.0
Moderate functional decline concrete thought processes, ADLs require set up and often direction during performance, need 24 hr care, benefit from supportive residential placement
3.5
Severe functional decline, poor use of familiar objects, total assist with ADLs, little speech, may be resistant with cares
2.5
Moderate to severe functional decline, concrete to object centered thought processes, cues needed during task, one on one for ADLs necessary
3.0
Severe functional decline, intermittently responsive
2.0
Late stage dementia, unresponsive to surroundings, comfort and hospice care
1.0
Represents sensory and perceptual info gathered from environment, serves to filter down vast arrays of info and retains only what is deemed as relevant for further processing
Sensory-perceptual memory
Enables us to combine info retrieved from LT memory with info that arrives from the environment, central role= release individual from reliance on fixed repertoires and reactions and to allow mental representations of alternatives, DRIVES ALL OCC. PERFORMANCE
Working memory
Comprises explicit and implicit stores
Explicit= episodic and semantic Implicit= procedural, perceptual priming, conditioning
Long term memory
Long term store most severely affected in AD, inability to recall newly presented info= one of the earliest signs of the disease
Episodic (LT) memory
More stable memory with less decline in AD, retaining conceptual knowledge of the world
Have this until later in disease
Semantic memory
remembering names of objects
Semantic recall
Getting lost in familiar places
spatial disorientation
Constellation of motor, perceptual, and skills associated with movement or skill based info
Most durable form of memory, deteriorates slower
Procedural memory
Is recall or recognition more demanding?
Recall
What does CMS stand for?
Center for Medicare Services
Patient with a documented fall 2+ times in last year or any any fall with injury in past year, should be reported on physician quality reporting initiative (PQRI), and a care plan should be developed to reduce further risk of falling
CMS
What fraction of adults 65+ fall each year?
1/3
What percentage of fractures in elderly are result of falls?
87%
What % return home after a fall?
60%
Why does fear of falling increase risk for falls?
Decline in mobility, activity, and confidence, fear of toileting- drink less, drinking less causes electrolyte imbalance which leads to impaired cognition, leading to another fall
Detects motion, spatial orientation for postural alignment and adjustment to environment
Visual aging effects on balance
Labyrinth system hair cells reduce in number and information is less reliable
Vestibular aging effects on balance
Threshold increases of joint, muscle and cutaneous receptors leading to slower reaction time
Proprioceptive aging effects on balance
Ability to remain upright when one’s posture has been disturbed
Balance
Most falls occur during __________ movements? Or when __________?
Transitional, multi-tasking
Response to vestibular and proprioceptive processing from stimuli
Righting reactions
