OLDER ADULTS Flashcards
dementia symptoms
- impaired understanding/judegment
- memory loss
- personality changes
- delusions
- elation/euphoria
- depression/anxiety
- hallucinations
- problems with thinking speed
diagnosing dementia
- GP: discuss symptoms/blood tests/mental agility test
- brain scans: rule out other causes (CT/MMRI/PET/EEG)
experimental diagnoses for dementia
wang et al. (2016)
amyloid imaging detects key feature of alzheimers
risk factors for dementia
- prior mental health (stewart, 2019)
- anxiety (acosta, 2018)
rarer causes of dementia
- HIV
- Huntington’s
- MS
- Parkinson’s
prevention of dementia
- reduce risk by having healthy diet, exercise, not drinking much alchohol, not smoking, healthy weight
- vitamin/thyroid hormone deficiencies (treated with supplements)
Livingston et al. (2017) - prevention
- individualise care (medical/social/supportive)
- be ambitious about prevention/intervention (e.g. maintain social engagement, obesity, depression and diabetes)
dementia cures
gene therapy
dementia vaccine
stem cells
gene therapy
introduce new gene that infects host cell and removes faulty gene
dementia vaccine
vaccination of antigen to remove excess plaques which contribute to dementia
treatment - surgery
dementia caused by brain tumours/excess fluid on brain/head injuries
treatment - medication
- antidepressants
- drugs to block chemicals in brain
- antipsychotics
symptomatic relief (Sadaghiani, 2014) benefits often modest
treatment - cognitive stimulation therapy (CST)
- mild/moderate dementia
- weekly one hour sessions that stimulate cognition
- group
- cognitive stimulation based on psychological factors that can be manipulated (yates et al., 2015)
- individual CST being run to determine effectiveness
treatment - validation therapy
- emotional impact of memory loss
- validating person’s experience as real
- results about effectiveness are inconclusive (Neal + Barton-Wright, 2003)
treatment - behavioural therapy
- alleviate symptoms (e.g. depression)
- effective in long-term (Livingston et al., 2005)
- debate about whether people with dementia can change their behaviour)
importance of family relationships (Fontaine, 2014)
- important
- previous/current relationship quality influence family experience of dementia
- families benefit from psychosocial interventions
care plans
- should include end of life care
e. g. advance statement about future care, will, living will, lasting power of attorney to someone
psychological impact on sufferer
- live with awareness of how they’re changing
- appreciation of family + friends
- not necessarily a loss of identity
social impact on sufferer
- media often present dementia as catastrophic (Peel, 2014)
- limited evidence for effectiveness of support services
- ‘felt totally alone’
psychological impact on family - burden
- closer relationships = higher burden
- no difference between spouses/adult children (chumbler, 2003)
- female caregivers - more health problems/depressive symptoms (gender differences not consistently shown though)
- more burden = less life satisfaction (McConaghy + Caltabiano, 2005)
- practical coping methods are effective
psychological impact on family - social isolation
- social isolation reported
- however caregivers also did not report feeling socially isolated (Robison et al., 2009)
- isolation predicts burden
psychological impact on family - stress
stress associated with behaviour/cognitive/functional impairment of person with dementia (Schultz + Sherman, 2005)
psychological impact on family - coping
- female caregivers - more emotional focused coping than men (almberg et al., 1997)
- men - problem focused coping (almberg et al., 1997)
- internet based interventions can be helpful
effective interventions for family carers
- START scheme
- REACH
reduce risk of depression/treat symptoms
should be made available for everyone
