Module 4: Neurocognition and aging Flashcards
Is dementia under the major or minor nerocognitive disorder?
Major
What umbrella is dementia under?
Major neurocognitive disorder
What condition is described below:
Characterize by psychological and behavioral symptoms, as well as acquired deficits in IADLs at more mild stages and increased dependency in all aspects of care as the disease becomes severe.
Dementia
The DSM 5 includes the following as neurocognitive disorders
- Delirium
- Mild neurocognitive disorder (MCI)
- Major neurocognitive disorders (dementia)
What conditions increase peoples chances of MCI?
- Diabetes
- Depression
- Stroke
Do people with MCI experience personality changes?
No
What are some signs of MCI?
- Losing things often
- Forgetting to go to events or appointments -
- Having more trouble coming up with words than other people the same age
True of false:
Movement difficulties and problems with the sense of smell have also been linked to MCI
True
True or false:
Researchers have found that more people with MCI than those without it go on to develop Alzheimer’s disease or a related dementia?
True
True or false:
All people that have MCI develop dementia
False
Name the types of dementia
- Alzheimers
- Lewy body dementia
- Frontotemporal dementia
- Vascular dementia
True of false:
1 in 3 seniors die of symptoms related to Alzheimers and other dementia
True
What are the most common neurodegenerative diseases in the OA population?
- Alzheimers
- Parkinsons
What are the least common neurodegenerative diseases in the OA population?
- MS
- Atypical parkinsons (ataxia)
-HD
-ALS
According to the DSM 5, what are the 6 neurocognitive domains?
- Perceptual Motor Function
- Language
- Learning & memory
- Social cognition
- Complex attention
- Executive function
Describe perceptual motor funciton
- Visual perception
- Visu constructional reasoning
- Perceptual motor coordination
Describe language of neurocognition
- Object naming
- Word finding
- Fluency
- Grammar and syntax
- Receptive language
Describe learning and memory of neurocognition
- Free recall
- Cued recall
- Recognition memory
- Semantic and autobiographical long term memory
- Implicit learning -
Describe social cognition of neurocognition
- Recognition of emotions
- Theory of mind
- Insight
Describe complex attention of neuro cognition
- Sustained attention
- Divided attention
- Selective attention
- Processing speed
Describe executive function of neurocognition
- Planning
- Decision making
- Working memory
- Inhibition
- Flexibility
- Responding to feedback
What lobe of the brain is responsible for the following:
- Visual perceptual and visual motor function
Occipital lobe
What lobe of the brain is responsible for the following:
- Learning & Memory
- Language
- Managing emotions
Temporal lobe
What lobe of the brain is responsible for the following:
- Executive functions
- Social cognition
- Complex attention
Frontal lobe
What lobe of the brain is responsible for the following:
- Perceptual-motor function
- Language
- Processing sensory input
Parietal lobe
Name some performance based assessments used to assess functional cognition
- Executive function performance test (EFPT)
- Performance Assessment of Self Care Skills (PASS)
- Weekly Calendar Planning activity
- Multiple Errands Test (MET)
What are some skill based assessments for functional cognition?
- MOCA
- SLUMS
- MMSE
- Trails A/B
- ACLS
What is the 7th leading cause of death in america?
Dementia
What are some risk factors of dementai?
- Age (strongest risk factor), risk doubles every 5 years after age 65
- Genetics
- Poor heart health
- Race/Ethnicity: African Americans more likely as well as Hispanics
- Those with head injury
- Lower levels of education
- Less access to health care
- Social isolation can increase risk
- Lower socio economic status
What is the most common type of dementia?
Alzheimers
Do more men or women get AD?
Women
What type of dementia is described below:
- Insidious onset
- Gradual progression
- Memory loss (evident early on i.e losing things)
- Difficulty with new learning
- Loss of orientation to place/situation/time
- Difficulty communication (withdrawal from work/social stuff)
- Depression, sleep issues
- Neuropsychiatric symptoms
- Visuospatial and language deficits
- Gait disturbances
Alzehimers dementia
What is the second most common type of dementia?
Vascular
The following describe which type of dementia?
- Change in personality/mood
- Slow processing speed
- EF difficulty, loss of cognitive flexibility
- Gait & balance impairment
- Incontinence
- Symptoms of depression, anxiety and apathy
- Can be caused by CVE (cerebral vascular event)
- Can be caused by small vessel disease
Vascular dementia
Name the 2 types of frontotemporal dementia
- Behavior variant
- Primary Progressive Aphasia
The following describes what type of dementia?
- Behavior & personality changes (often with loss of impulse control)
- Impaired judgement and degreased self awareness
- Apathy and loss of interest
- Agitation and mood changes
- Inability to use/understand language
- Hesitation when speaking
- Loss of EF skills
Frontotempral dementia
What level of dementia is this?
- Forgetfulness of words/names
- Misplacing and losing things
- Decline in goal oriented behavior
- Getting confused or disoriented in familiar places
- Losing track of time
- Poor judgement/decision making
- Concrete thinking, loss of abstraction
- Impaired safety awareness
- Visuospatial changes
- Mood changes
- Impaired attention to tasks
- Difficulty with IADLs
- Can complete ADLs, but nay need help with setup
- Can access community with some risk of getting lost
- More successful in structured environment
- ACL 4.4-4.8
Mild stage
What level of dementia is this?
- Increased loss of orientation
- Not able to manage environment effectively
- Communication difficulty, decreased use of language
- Likely to have visuospatial issues
- Poor attention to safety
- Increased impulsivity
- Loss of much purposeful activity
- Difficulty with ADLs (requires assist) (may be incontinent)
- Requires cues to maintain routine
- Assistance for all IADLs
- Community activity is limited
- Neuropsychiatric symptoms arise of increase (i.e hallucinations, wandering)
- At risk for wandering from home
- Gait and balance impairment (high fall risk) might not use AE safely
- Can no longer live alone
- ACL 3.6-4.2
Moderate level
What level of dementia is this?
- No longer oriented
- Language is limited, can follow 1 step instructions, may speak with short sentences
- Assist for all ADLs (may need 2 assist)
- Bladder/bowel incontinent
- Assist to eat/supervision
- Benefits from sensory engagement
- Weight loss
- Physical assistance for movement
- Likely to have visuospatial issues
- High fall risk
- Possible increase in behaviors (may be resistant to care)
- At risk for pressure ulcers, aspiration, poor nutrition
- Requires 24 hour care setting
- ACL: 3.0-3.4
Severe stage
What level of dementia is this?
- Limited responsiveness or ability to others
- Limited language if any
- Benefits from comforting stimuli (familiar voices)
- Likely bedbound
- Dependent for all care (including feeding)
- Difficult with swallowing
- Weight loss
- May require pain management
- May have increased tone
- May require supportive positioning
- Loss of mobility
- Agitation
- Risk of pressure ulcers
- Will likely require hospice care in addition to 24 hour care
- ACL 3.0 or less
Terminal dementia
