Neurocognitive Disorders COMPLETE Flashcards
What do we mean by late life
Life expectancy increasing dramatically:
Medical advancements and improved living conditions
Old usually defined as over 65- not universal- depends on the context.
In Ireland-determined by the pension age/ retirement age
What are the correlations between mental health and late life
Decline in cognitive and physical abilities
But they experience less negative emotions than young people
Why do they experience less negative emotions?
They’re more skilled in emotional regulation
Focus on more emotional, meaningful goals
They process negative events less
The pressures they experience in life decrease
Talk about the incidence of psychological disorders in old people
Older people have less psychological disorders
Newer disorders are very unlikely in late life
Why are the reasons which may influence the incidence of psychological disorders in old people
The stigma is reduced in young people, older people may be too embarrassed to speak up
Under- diagnoses
Misdiagnosis
Survivor bias- if they experienced issues younger in life, may have died
What issues are looked into in regards to old people?
Age effects- the consequences of being a certain age- correlationary side
Cohort effects- the consequences of growing up during a particular time periodic. During war, after war
(Born after war had more bad mental health than during war)
Time of Measure effects- Things that happen during the time of research that interfere, ie. Doing a study on loneliness but then covid happens.
What are the research methods in the study of ageing?
Cross sectional studies
Longitudinal studies
Describe cross sectional studies
Comparing a variable interest between different age groups at same time
What study was conducted as a cross sectional study for ageing
Charles (Positivity Bias)
Memory test regarding images
Older people remembered less of the material in every condition
But they remember more of the positive items than the negative items
What’s the issue with cross sectional studies
Cant rule out the cohort effect
What are longitudinal studies
Periodically testing one group of people using the same measure over a number of years
Use a cohort of people who share defining characteristic
What did Snow et al study?
Nuns studied
When they examine the autobiography, those that used more positive feelings in their autobiography, they lived longer.
What’s the difference between cross-sectional and longitudinal studies
They produce very different results
Cross-sectional doesn’t take into account that cohorts may differ in access to education/work
What is dementia caused by?
Brain damage by diseases like Alzheimer’s
The symptoms depend on the parts of the brain that are damaged and by the disease that caused it.
Whats the most leading cause of dementia?
Alzheimer’s- 60-80%.
What is the prevalence of dementia
1-2% of people in their 60s
20% of people above 85.
What are some warning signs of dementia
Problems with language
Memory loss
Disorientation
Problems with keeping track of things
What is the trajectory of dementia?
150 million people world wide in 2050
Increases disproportionately in low and moderate income countries-may be due to lifestyle and health related risks
This is due to the increases in life expectancy
What are some risk factors associated with preventing dementia
12 modifiable risk factors can prevent/delay the onset of dementia
Examples Include:
Smoking
Depression
Obesity
Alcohol
Talk about potential and dementia prevention
Greater potential for dementia prevention in LMIC
What other ways can dementia be prevented?
The finger study- ngandu
Cognitive training programs
What was the finger study
Ngandu conducted double blind randomised trial on ppl ages 60-77
Intervention was 2 years of diet and exercise and cognitive training
Control received general health advice
Intervention group symptoms improved
What are cognitive training programs
Controversial, may be that companies are profiting without it actually being beneficial
HAs been some slight improvement in people with cognitive impairment
Studies mostly inefficient to show the effects
What is Alzheimer’s disease
Degenerative disease which causes irreversible deterioration of brain tissue- loss of grey matter
Short term memory loss is a common symptom
Accounts for 60-80% of dementia
Death usually occurs within 12 years of the onset of symptoms
What symptom is present at the early stage of Alzheimer’s
Absent-mindedness
What symptoms are present as Alzheimer develops
Inability to find right words
Lack of visual/spatial skills
What is the pathophysiology of Alzheimer
Plaques- beta-amyloid protein outside neurons
Neurofibrillary tangles- protein tou inside axons of neurons
What gene predispose people for Alzheimer’s and which protects against it
APOE4- Apolioprotein E4
APOE2
Why does APOE4 effect Alzheimer’s
Not well understood
The protein helps carry cholesterol in the blood stream
Problems with brain cells ability to process fats/lipids may play a key role in Alzheimer’s
What are the types of treatment for Alzheimer’s
No disease-modifying treatment
Medication can help slow decline but they don’t restore memory function to previous levels
What medication is used to treat alzehimers
Cholinesterase inhibitors
What are other forms of alzehimers treatment
Behavioural approaches, visual aids
Music therapy
What are the psychological and lifestyle treatments for Alzheimers
Psychotherapy for patients and families
Caregiver interventions- increasing social support, pleasant activities, exercise
How is Alzheimer early detected?
Beta amyloid plaques may be present 20-30 years before any cognitive symptoms- not reversible
Genetic markers are detectable from birth
What’s frontotemporal Dementia
Caused by a loss of neurons in frontal and temporal regions of the brain
Build up of proteins, liked to ALS
Younger onset- mid to late 50’s
What’s FTD prevalence
Less than 1% of the population
What are the variants of FTD
Behavioural variant
Primary progressive aphasia PPA variants
Explain Behavioural Variant of FTD
Decreased empathy
Personality changes
Increased compulsivity
Explain Primary progressive aphasia PPA variants
Semantic dementia- naming things, ppl losing meaning of words
Progressive non-fluency aphasia- pronouncing things
Logopenic aphasia- speaking slowly
What is the medication treatment for FTD
Medication
Antidepressants- to treat depression and compulsivity
Antipsychotics- severe agitation and compulsivity
What are some non-pharmacological treatements for FTD
Family therapy
Speech therapy
Lewy body dementia
Caused by abnormal deposits of protein alpha - synuclein
Lewy bodies affect chemicals in the brain- leads to thinking and behavioural problems
Onset age 50 years- die after 5-8
Often misdiagnosed due to similar symptoms w other conditions
What are the symptoms of Lewy Bodies
Visual hallucinations/ disorganised thinking/memory problems
Depression/ severe agitation/paranoia
Tremor/balance issues /slow movement
Insomnia/ REM behaviour disorder
What is the medication treatment for the cognitive symptoms of Lewy body dementia
Cholinesterase inhibitor
What is the medication treatment for the movement symptoms of Lewy body dementia
Levodopa
What is the medication treatment for the REM sleep behaviour for Lewy body dementia
Clonazepam/melatonin
What is the medication treatment for the depression for Lewy body dementia
Anti depressants
What is the medication treatment for the severe agitation/paranoia?
Anti psychotics
What are the non- pharmacological treatments for levy body dementia
Physical therapists
Occupational therapists
Speech therapists
What is delirium?
A clouded state of consciousness
Trouble focusing
Disturbances in sleep/wake cycle
Within 24 hours, they have lucid intervals where they become alert and coherent
What are the contributing factors of delirium
Medication
Infection surgery alcohol
Drug intoxication/withdrawal
