older adults, dementia, delirium Flashcards
3 aspects of successful aging
- absence of disease
- engagement with life
- preserved cognitive and physical function
genetics accounts for how much of physical and mental aging?
30% of physical and 50% of mental
what is the largest factor affecting premature death? what is the second?
1) behavior
2) genetics
what are the three psychological processes of successful aging?
selection - fewer life domains
optimization - augmentation of reserves, maximize functioning
compensation - use psychological and technological aids
dementia is now called……under DSM-V
major neurocognitive disorder
diagnosis of major neurocognitive disorder
- 1 or more significant cognitive impairments
- interfering with daily function
- NOT IN CONTEXT OF DELIRIUM
diagnosis of minor neurocognitive disorder
- 1 or more modest cognitive impairments
- does not interfere with daily function
- NOT IN CONTEXT OF DELIRIUM
5 types of major neurocognitive disorder
1) alzheimers
2) vascular disease
3) frontotemporal lobar degeneration
4) lewy body disease
5) parkinsons
what are the 6 cognitive domains?
- memory
- language
- social cognition
- attention
- executive function
- perceptual motor ability
progression of alzheimers
- short term memory loss
- progresses to brain functions involving self care
- depression, anxiety, and psychosis are common comorbidities
alheimers risk factors
- age
- head trauma
- low education
- female gender
- cardiovascular risks, including obesity
genetics affecting early onset alzheimers
Presenelin-1 on chromosome 14
Presenelin-2 on chromosome 1
genetics affecting late onset alzheimers
APOE genotyping E4 on chromosome 19
amyloid precursor protein found where?
chromosome 21
accumulation of ……. is important in development of alzheimers
amyloid beta protein
explain role of presenelin in formation of
- presenelin is a subcomponent of gamma secretase
- gamma secretes along with beta secretase cleaves amyloid precursor protein to amyloid beta protein
contrast vascular disease with alzheimers in terms of deficit
- executive and attention affected earlier
- less memory loss
unique symptoms/deficits in frontotemporal lobar NCD
behavior/personality
- hyperorality
- disinhibition
- socially inappropriate
speech/language
executive function
lewy body disease symptoms
COGNITIVE IMPAIRMENT +
fluctuation in alertness
hallucinations
parkinsonism
alzheimers meds
MEMORY MEDICATIONS - only slow down the disease choline esterase inhibitors - donepezil - rivastigmine - galantamine NMDA receptor antagonist - memantine
delirium is a disturbance in ……
attention and awareness
or an additional disturbance in cognition
acute change in baseline
usually direct physiological consequence of another disease process or toxicity
cardinal symptom of delirium is ……..
new onset of fluctuation in mental status
does a negative medical workup rule out delirium?
no
neurotransmitters thought to be involved in delirium
DA up and ACh down
