Psychiatry in old age

Question 1

Name 3 stressors or circumstances of old age

Answer 1

Bereavement
Infirmity: weakness
Dependence
Sensory deficit
Isolation

Question 2

How does presentation of psychiatric disorders tend to differ between elderly patients and others?

Answer 2

Elderly patients are more likely to manifest physical symptoms of psychiatric disorders

Question 3

Outline the neurobiology of normal ageing

Answer 3

Brain mass decreases
Proportionate increase in ventricles and subarachnoid space
Changes in grey and white matter
Cerebral blood flow decreases

Tau proteins ➔ neurofibrillary tangles
Senile plaques: neocortex, amygdala, hippocampus
Lewy bodies: substantial nigra, locus coeruleus
Hirano bodies: new hippocampal pyramidal cells
Amyloid deposits: cortical vessels and cortex

Question 4

Outline the psychology of normal ageing

Answer 4

IQ peaks at 25, declines after 70
Performance IQ drops faster than verbal IQ
Problem solving deteriorates
Short-term/working memory gradually declines
Long-term memory declines
Episodic memory may be intact

Question 5

Outline the social problems of old age

Answer 5

Isolation, stigmatisation, marginalisation
Loss of status
Loss of independence
Loss of spouse/partner
Limited income/unemployed