Late Adult 1

Question 1

What are the three Ds of late adulthood?

Answer 1

Delirium
Dementia
Depression

Question 2

What is dementia?

Answer 2

a slow, progressive, and irreversible cognitive impairment

Question 3

What are the manifestations of dementia?

Answer 3

MEMORY IMPAIRMENT: ability to learn new information or recall previously learned info

one or more of APHASIA, APRAXIA, AGNOSIA, disturbance in EXECUTIVE FUNCTIONING

Must be sufficiently severe to cause impairment in social or occupational functioning

Question 4

What is effected first by dementia, STM or LTM?

Answer 4

STM

Question 5

What is aphasia?

Answer 5

impaired ability to communicate through oral or written language

Question 6

What are some of the signs of aphasia?

Answer 6

• difficulty in word finding
• vague speech
• difficulty comprehending spoken/written language
• unintelligible speech or muteness

Question 7

What is apraxia?

Answer 7

impaired ability to execute MOTOR functions despite motor abilities and sensory function

ex dressing is often affected

Question 8

What is agnosia?

Answer 8

loss of ability to recognize persons or things

Question 9

What are the two ways you would be able to see agnosia?

Answer 9

may not recognize everyday objects or familiar people

may not associate objects with their purpose

Question 10

What are executive functions?

Answer 10

Higher level brain functions (more complex/deep)

ex. planning, organizing, sequencing, abstracting

Question 11

What are 2 consequences of a disturbance in executive functioning?

Answer 11

Difficulty with new tasks, situations, information, and decisions

New learning is impossible

Question 12

List 4 types of dementia and the percentage of dementia patients affected by each

Answer 12

Alzheimer’s Disease >60%

Vascular dementia 20%

Frontotemporal dementia 5-15%

Lewy Body dementia 2-5%

Question 13

Approximately what percentage of Alzheimer’s patients experience delusions?

Answer 13

50%

Question 14

Approximately what percentage of Alzheimer’s patients experience depression and anxiety?

Answer 14

40%

Question 15

Approximately what percentage of Alzheimer’s disease experience hallucinations?

Answer 15

25%

Question 16

What behavioural disturbances may be associated with dementia?

Answer 16

• self-destructive behaviour
• non-compliance
• dependency
• aggression (verbal/physical)
• impulsiveness/disinhibition
• hiding/hoarding

Question 17

How long does the early stage in dementia progression usually last?

Answer 17

2-4 yrs

Question 18

What symptoms are associated with dementia in the early stages of dementia?

Answer 18

forgetfulness
denial
confusion
difficulty with ADLs
social withdrawal

family becomes aware and seek assistance

Question 19

What symptoms are associated with dementia in the middle stages of progression?

Answer 19

Significant impairment of ADLs

Decreased:
language skills
ability to reason/plan

Disinhibition and aggression

may be admitted to residential care

Question 20

How long does the end stage of dementia last?

Answer 20

1-2 yrs

Question 21

What symptoms are associated with the end stages of dementia?

Answer 21

Decreased engagement with environment

Dependent with ADLs

Decreased motor skills

Decreased speech

Question 22

What is delirium?

Answer 22

it is a cognitive impairment characterized by a sudden onset of altered behaviour and mental state

transient state with fluctuating symptoms

Question 23

What are some symptoms of delirium?

Answer 23

difficulty with attention

disoriented (date, time, location, people around them)

sensory disturbances ex hallucinations

sleep-wake disturbances (circadian cycle may become out of sync)

changes in psychomotor activity

anxiety, fear, irritability, euphoria, apathy

may be hyperactive: agitation, constant motion, repetitive movements

may be hypoactive: inactive withdrawn, decreased motor/verbal responses

or mixed: fluctuates

Question 24

What is depression?

Answer 24

an impaired cognitive state that affects mood directly

Question 25

What are the symptoms of depression?

Answer 25

at least 2 wks of depressed mood or loss of interest/pleasure in nearly all activities

change in appetite, weight, sleep, activity

feelings of worthlessness and guilt

difficulty thinking; making decisions

recurrent thoughts of death, suicidal ideation

impairment in social and occupational functioning

Question 26

State what percentage of the population suffers from depression in the community, acute care, and residential care for those >65yrs old.

Answer 26

Community: 15-21%

Acute Care: 21%

Residential Care: 40%

Question 27

What are the two most common infections associated with delirium?

Answer 27

UTI and pneumonia