Late Life Disorders Flashcards
Define
Vascular dementia
a form of dementia caused by cerebrovascular disease, most commonly occurring after strokes. Because the areas of the brain affected by the disease can vary, the symptoms of vascular dementia vary as well
Define
Mild cognitive impairment
cognitive decline, based on self/other reports and objective tests, which do not impact on function/daily activities
Definition
the consequences of being a given chronological age
Age effects
True or False:
There is no cure for dementia
True
Beyond treating the underlying medical conditions, the most common approach to treatment for delirium is to use __________ medications.
a) antidepressant
b) anxiolytic
c) mood stabilizing
d) atypical antipsychotic
d) atypical antipsychotic
Define
Selective mortality
the tendency for less healthy individuals to die more quickly, which leads to biased samples in long-term follow-up studies
What are the DSM-5 criteria for mild neurocognitive disorder?
- Modest cognitive decline from previous levels on one or more domains (e.g., complex attention, memory, language, executive function, social cognition) based on both of the following:
- Concerns of the patient, a close other or a clinician
- Modest neurocognitive decline on formal testing or equivalent clinical evaluation
- The cognitive deficits do not interfere with independence in everyday activities, even though greater effort, compensatory strategies or accommodation may be required to maintain independence
- The cognitive deficits do not occur exclusively in the context of delirium and are not due to another psychological disorder
Definition
a state of mental confusion with respect to time; place; and identity of self, other persons and objects
Disorientation
Definition
prescription of multiple medications to an individual, traditionally defined as the use of five or more medications
Polypharmacy
Gerontologists usually define the word “old” as meaning above age 65, based on
a) life span estimates.
b) prevalence of illnesses.
c) typical retirement age.
d) social policies.
d) social policies.
When are pharmacological treatments used to treat delirium?
If the person’s behaviour or emotions impact on his/her safety or the safety of others or interfere with medical treatments antipsychotics may be used
Definition
cognitive decline, based on self/other reports and objective tests, which do not impact on function/daily activities
Mild cognitive impairment
What are the different types of delirium?
Hyperactive
Hypoactive
Mixed delirium
One way that delirium in an elderly person can be distinguished from dementia, such as Alzheimer’s, is by the
a) rapid onset of symptoms in delirium.
b) presence of cognitive symptoms.
c) severity of symptoms.
d) age of onset.
a) rapid onset of symptoms in delirium.
Define
Dementia
deterioration of mental faculties - memory, judgement, abstract thought, control of impulses, intellectual ability - that impairs social and occupational functions, and eventually changes the personality
Define
Alzheimer’s disease
a dementia involving a progressive atrophy of cortical tissue and marked by memory impairment, intellectual deterioration and loss of motivation
Longitudinal studies may provide more clarity about age and cohort effects, but the validity of findings can be challenged by what?
Attrition
Define
Cognitive reserve
the idea that some people may be able to compensate for impacts of disease in the brain by using alternative brain networks or cognitive strategies such that cognitive symptoms are less pronounced
Definition
small, round areas composed of remnants of lost neurons and beta-amyloid, a waxy protein deposit; present in the brains of patients with Alzheimer’s disease
Plaques
What are the primary symptoms of bvFTD?
Marked changes in social and emotional behaviour
Define
Cohort effects
the consequences of having been born in a given year and having grown up during a particular time period with its own unique pressures, problems, challenges and opportunities
Definition
dementia that begins typically in the mid- to late 50s, characterised by deficits in executive functions such as planning, problem solving and goal-directed behaviour as well as recognition and comprehension of emotions in others
Frontotemporal dementia (FTD)
True or False:
National surveys suggest lower rates of psychological disorders among the elderly compared to other age groups
True
What are the DSM-5 criteria for major neurocognitive disorder?
- Significant cognitive decline from previous levels in one or more domains (e.g., complex attention, memory, language, executive function, social cognition) based on both of the following:
- Concerns of the patient, a close other or a clinician
- Substantial neurocognitive impairment, preferably documented by standardised neuropsychological testing or equivalent clinical evaluation
- The cognitive deficits interfere with independence in everyday activities
- The cognitive deficits do not occur exclusively in the context of delirium and are not due to another psychological disorder
What is the main medical treatment for dementia?
Cholinesterase inhibitors
Define
Frontotemporal dementia (FTD)
dementia that begins typically in the mid- to late 50s, characterised by deficits in executive functions such as planning, problem solving and goal-directed behaviour as well as recognition and comprehension of emotions in others
The course of dementia may be
a) progressive.
b) static.
c) remitting.
d) all of the above
d) all of the above
Define
Plaques
small, round areas composed of remnants of lost neurons and beta-amyloid, a waxy protein deposit; present in the brains of patients with Alzheimer’s disease
What is the treatment of delirium?
Identifying and treating the underlying cause, preventative strategies and non-pharmacological strategies (e.g. normalising sleep patterns, reorientation, minimising hearing or visual impairments)
What are the DSM-5 criteria for delirium?
- A disturbance in attention and awareness
- A change in cognition, such as disturbance in orientation, language, memory, perception or visuospatial ability, not better accounted for by dementia
- Rapid onset (usually within hours or days) and fluctuating during the course of a day
- Symptoms are caused by a medical condition, substance intoxication or withdrawal, or toxin
Define
Delirium
a state of great mental confusion in which consciousness is clouded, attention cannot be sustained and the stream of thought and speech is incoherent. The person is probably disorientated, emotionally erratic, restless or lethargic and often has illusions, delusions and hallucinations
Definition
a form of dementia caused by cerebrovascular disease, most commonly occurring after strokes. Because the areas of the brain affected by the disease can vary, the symptoms of vascular dementia vary as well
Vascular dementia
Definition
abnormal protein filaments present in the cell bodies of brain cells in patients with Alzheimer’s disease
Neurofibrillary tangles
Treatment for Alzheimer’s disease include drugs that interfere with the breakdown of
a) dopamine.
b) acetylcholine.
c) serotonin.
d) adrenaline.
b) acetylcholine.
Define
Polypharmacy
prescription of multiple medications to an individual, traditionally defined as the use of five or more medications
Definition
a possible confound in longitudinal studies whereby conditions at a particular point in time can have a specific effect on a variable that is being studied over time
Time-of-measure effects
Define
Age effects
the consequences of being a given chronological age
Definition
denoting a disease that progresses gradually with inapparent symptoms
Insidious onset
What are some challenges associated with becoming older?
Declining health
Changes in sleep
Death of loved ones
Neuronal deterioration of the frontal and temporal lobes is typical of what type of dementia?
Frontotemporal dementia
Define
Disorientation
a state of mental confusion with respect to time; place; and identity of self, other persons and objects
What are the positive mental aspects of aging?
As we age, we tend to become more effective at regulating emotions, to downplay medical symptoms and to focus on core relationships
Definition
the tendency for less healthy individuals to die more quickly, which leads to biased samples in long-term follow-up studies
Selective mortality
Definition
the consequences of having been born in a given year and having grown up during a particular time period with its own unique pressures, problems, challenges and opportunities
Cohort effects
Treatment approaches that attempted to remove the plaques from the brains of people affected with Alzheimer’s disease
a) dramatically improved memory and planning deficits.
b) led to continued or even worsening cognitive deficits.
c) improved memory deficits but not other symptoms of the disorder.
d) had a fairly neutral impact on disease progression.
b) led to continued or even worsening cognitive deficits.
Define
Social selectivity
the late-life shift in interest away from seeking new social interactions and towards cultivating those few social relationships that matter most, such as with family and close friends
Which allele increases the chance of getting Alzheimer’s disease?
ApoE-4
What effects can bias results of aging studies?
Age effects
Cohort effects
Time-of-measurement effects
Which age-related disorder is characterised by visual hallucinations, fluctuations in cognitive functioning and sensitivity to side effects of antipsychotic medications?
Dementia with Lewy bodies
What are the two main variants of FTD?
Behavioural and language
Definition
a form of dementia that often co-occurs with Parkinson’s disease; characterised by shuffling gait, fluctuating attention and cognition, and hallucination and delusions
Dementia with Lewy Bodies (DLB)
What do the symptoms of vascular dementia depend on?
The brain regions that are affected by the cerebrovascular damage
Define
Dementia with Lewy Bodies (DLB)
a form of dementia that often co-occurs with Parkinson’s disease; characterised by shuffling gait, fluctuating attention and cognition, and hallucination and delusions
Define
Insidious onset
denoting a disease that progresses gradually with inapparent symptoms
Definition
a state of great mental confusion in which consciousness is clouded, attention cannot be sustained and the stream of thought and speech is incoherent. The person is probably disorientated, emotionally erratic, restless or lethargic and often has illusions, delusions and hallucinations
Delirium
Definition
the idea that some people may be able to compensate for impacts of disease in the brain by using alternative brain networks or cognitive strategies such that cognitive symptoms are less pronounced
Cognitive reserve
Define
Time-of-measure effects
a possible confound in longitudinal studies whereby conditions at a particular point in time can have a specific effect on a variable that is being studied over time
Definition
a dementia involving a progressive atrophy of cortical tissue and marked by memory impairment, intellectual deterioration and loss of motivation
Alzheimer’s disease
Define
Neurofibrillary tangles
abnormal protein filaments present in the cell bodies of brain cells in patients with Alzheimer’s disease
Which disease is a cause of frontotemporal dementia?
a) Lyme’s
b) Parkinson’s
c) Alzheimer’s
d) Pick’s
d) Pick’s
Definition
deterioration of mental faculties - memory, judgement, abstract thought, control of impulses, intellectual ability - that impairs social and occupational functions, and eventually changes the personality
Dementia
Definition
the late-life shift in interest away from seeking new social interactions and towards cultivating those few social relationships that matter most, such as with family and close friends
Social selectivity
Why is it important to evaluate potential medical causes when older adults present with psychological disorders?
The elderly are particularly susceptible to the negative effects of medical conditions and medications, and these effects may mimic psychological conditions
What type of dementia occurs after a stroke?
Vascular dementia