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Adult Development & Aging > Test 2 > Flashcards

Test 2 Flashcards

1
Q

What are the 2 primary classification systems to diagnose a mental illness?

A

Diagnostic and Statistical Manual (DSM-5)
&
International Classification of Diseases (ICD-11)

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2
Q

5 characteristics of the DSM-5

A
  • focuses only on mental disorders
  • can be updated quickly
  • mainly used in Canada and USA
  • mainly used by psychiatrists
  • focuses on secondary psychiatric care in high income countries
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3
Q

5 characteristics of ICD-11

A
  • includes all physical ailments & mortality rates
  • cannot be updated quickly because the whole book would need revision
  • more attention is given to primary care in low & middle income countries
  • created for the use of all healthcare providers
  • only has one diagnosis for PD
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4
Q

How many Canadians in a given year over the age of 15 are living with a mental illness?

A

1 in 5 (20%)

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5
Q

What are the 2 most common mental illnesses and their prevalence rate in Canada?

A

Mood & anxiety disorders account for about 70% of all mental disorders in Canada

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6
Q

3 criteria used when determining if an individual has a mental illness

A
  • how different is the behavior?
  • how disruptive is the behavior?
  • to what degree is the person distressed by the behavior?
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7
Q

3 criteria that formal patients must meet in order to be admitted (Mental Health Act)

A
  • the individual has a mental disorder
  • the individual is likely to cause serious harm to themselves
  • the individual suffers substantial mental or physical deterioration or serious physical impairment
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8
Q

define performance-based assessment

A

allows clinicians to observe how a person functions in their own environment

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9
Q

define IADLs and 2 examples

A

instrumental activities of daily living

can a person safely prepare their meals? can they pay bills?

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10
Q

define ADLs and 2 examples

A

activities of daily living

brushing one’s teeth, washing one’s face

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11
Q

4 factors that can influence assessment

A
  • positive & negative biases that healthcare workers may have
  • the environment that the assessment occurs in (eg. loud room)
  • not considering personal factors (eg. ESL)
  • not having appropriate norms to compare the cognitive performance of the person being assessed
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12
Q

what is the most common mood disorder?

A

depression (major depressive disorder, MDD)

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13
Q

define depression for a formal diagnosis

A

loss of interest in activities that one previously enjoyed and low mood

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14
Q

5 symptoms of depression

A
  • feelings of worthlessness & hopelessness
  • excessive guilt
  • lack of motivation
  • weight loss
  • negative thoughts about oneself, the world, and the future (negative triad)
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15
Q

which age groups have the highest and lowest rates for depression?

A

highest: ages 18-34
lowest: ages 65+

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16
Q

what are the depression in LTC ranges? (worldwide & in Canada)

A

worldwide: 11% - 85%
Canada” 14% - 44%

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17
Q

what is SSD and who is most likely to present it?

A

subsyndromal depressive symptoms are less severe symptoms of depression that interfere with daily functioning

older adults are more likely to present

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18
Q

5 risk factors for depression

A
  • physical illness
  • low social support
  • isolation
  • poor subjective health, recent bereavement
  • change in residence
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19
Q

a combination of pahrmacotherapy & psychotherapy can be used for the treatment of what disorder? give 3 examples

A

depression

  • SSRIs (selective reuptake inhibitors), SNRIs (serotonin & norepinephrine reuptake inhibitors), and atypical antidepressant (bupropion & mirtazapine)
  • ECT (eclectroconvulsive therapy)
  • CBT, group therapy, PST (probem-solving therapy), and mindfulness-based cognitive therapy
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20
Q

what is the most common mental disorder?

A

anxiety disorders

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21
Q

define anxiety disorders

A

symptoms like nervousness, fear, and worry that interfere with an individual’s ability to function

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22
Q

10 symptoms of anxiety disorders

A
  • fear
  • worry
  • nervousness
  • increased heart rate
  • sweating
  • dry mouth
  • chest pain
  • hyperventilation
  • diarrhea
  • insomnia
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23
Q

what is the most common anxiety disorder found in older adults?

A

GAD (generalized anxiety disorder)

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24
Q

what are the prevalence rates for GAD and which gender is it higher for?

A

1% - 17%

higher for women

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25
Q

what are the treatments for anxiety disorders?

A
  • SSRIs
  • CBT, supportive discussion groups, relaxation therapy
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26
Q

define late-onset alcohol-use disorder and how many older adults alcoholics fall into this category?

A

older adults who have been abusing alcohol before 60 y/o

2/3 older adults alcoholics fall into this category

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27
Q

psychotic disorders include abnormalities in at least 1 of the 5 domains…

A
  • delusions
  • hallucinations
  • disorganized thinking (speech)
  • abnormal motor behavior (including catatonia)
  • negative symptoms
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28
Q

what is the difference between a primary psychosis and a secondary psychosis

A

primary: psychosis caused by a psychiatric illness
secondary: psychosis caused by a medical/neurologic condition

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29
Q

___% of psychotic disorders in older adults are due to ___

A

60% are due to a medical/neurologic condition

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30
Q

4 risk factors for psychosis

A
  • poor health status
  • cognitive problems
  • visual impairment
  • negative life events
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31
Q

what are the 2 types of symptoms of schizophrenia & 2 examples for each

A

Negative symptoms: something is taken away from the person (reduced motivation, inability to show emotions)

positive symptoms: something is added to the person (hallucinations, delusions)

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32
Q

what is the prevalence of schizophrenia in older adults?

A

0.1% - 0.5%

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33
Q

when are men and women most likely to be diagnosed with schizophrenia?

A

men: before the age of 40
women: after the age of 60

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34
Q

what is the course of schizophrenia? 3 points per period

A

Symptom onset & early course:
Frequent losses
Unstable financial support
Confused about the symptoms

Middle course: adaptations to symptoms:
Transition period
Symptom improvement
Learn self managing/coping strategies

Present & future outlook:
Despair over lost opportunities
resignation/acceptance of current situation
Hope & optimism

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35
Q

define hoarding disorder

A

Is the persistent difficulty in discarding or parting with possessions, regardless of their actual value

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36
Q

when does hoarding disorder begin and when does it get identified/treated

A

usually begins in childhood or adolescence

usually doesn’t get identified/treated until one’s 50s

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37
Q

what are the prevalence rates for hoarding disorder?

A

2.3%

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38
Q

5 characteristics of those with hoarding disorder

A
  • unmarried, live alone
  • have a strong affection for objects, emotional sensitivity, and perfectionism
  • problems with executive functioning
  • can be linked to OCD
  • MDD is usually a co-morbidity
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39
Q

what is the treatment for hoarding disorder?

A

CBT

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40
Q

define problem-focused coping and who is most likely to use it

A

involves using coping strategies that attempt to change the problem in some way

Tend to be used more by younger adults

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41
Q

define emotion-focused coping and who is most likely to use it

A

involves coping strategies that deal with the feelings associated with the problem

Tend to be used more by older adults

42
Q

define positive psychology and what i has shown to decrease and improve

A

Is the scientific study of strengths, well being and functioning

shown to decrease depressive symptoms and pessimism

shown to improve life satisfaction, psychological well-being, resilience, and hope

43
Q

define neurocognitive disorder

A

having a decline in 1 or more areas of cognitive functioning

44
Q

define mild neurocognitive disorder

A

modest cognitive decline from a previous level of functioning which does not significantly interfere with daily activities

45
Q

define major neurocognitive disorder

A

significant decline from a previous level of functioning which interferes significantly with daily activities

46
Q

define fronto-temporal neurocognitive disorder (FTD) and which areas of the brain in affects

A

a cluster of syndromes that result from degeneration of the frontal & temporal lobes

affects areas of the brain linked to personality & behavior

47
Q

define the behavioral type of FTD

A

a person’s mental filter is altered so that social rules are no longer considered when talking/behaving

48
Q

define the 2 language types of FTD

A

non afluent aphasia: difficulty communicating orally and with written words

primary progressive aphasia: language capabilities become slowly and progressively impaired

49
Q

define neurocognitive disorder with lewy bodies

A

involves progressive cognitive impairment which appears to affect complex attention & executive function rather than learning & memory

50
Q

what can be experienced with neurocognitive disorder with lewy bodies

A
  • hallucinations
  • sleep issues
  • delusions
  • repeated falls
  • fluctuations in cognitive abilties
  • maybe parkinson-like symptoms
51
Q

define alcohol-related dementia and what is it often caused by

A

due to excessive & prolonged use of alcohol which leads to damage to the structure & function of the brain

Often caused by thiamine deficiency or a number of underlying factors (neurotoxicity & nutritional deficiencies)

52
Q

define delirium

A

acute deterioration of mental status in which an individual exhibits deficits in attention, altered levels of consciousness, & psychotic features

symptoms are treatable and tend to go undetected in older adults

53
Q

symptoms of delirium

A
  • develop over time and fluctuate throughout the day
  • could resolve after a few days or months
  • impairment in vision
  • difficulty having simple conversations
54
Q

reversible causes of delirium

A
  • infections
  • sensory impairment
  • trauma
  • surgery
  • constipation
  • adverse drug effects
55
Q

define mild cognitve disorder MCI

A

a range of diseases that include impairment in both memory & non-memory cognitive domains & does not interfere with daily life acitivites

56
Q

define the 2 types of MCI

A

amnestic MCI: where memory loss is the main symptom & is most common subtype of MCI

non-amnestic MCI: memory is not impaired, but other thinking abilities may be affected (planning, judgment, organizing, etc)

57
Q

define vascular dementia

A

dementia caused by brain damage

58
Q

what is the 2nd leading cause of dementia

A

vascular dementia

58
Q

what can vascular dementia be caused by

A

cerebral vascular incident (stroke) –> sudden onset with gradual progression or fluctuating decline

ischemic stroke: sudden brain blood vessel blockage → most common

hemmorrhagic stroke: sudden brain blood vessel rupture

cerebral small vessel disease: which arises from damage to small arteries, arterioles, capillaries, and white matter lesions (small veins in the brain) –> gradual onset with slow progression

59
Q

7 communication difficulties among people with dementia

A
  • Word finding difficulties
  • Creating new words for those that are forgotten
  • Repeating words or phrases (perseveration)
  • Difficulty organizing words into logical sentences
  • Cursing or using offensive language
  • Reverting back to the language that was first learned
  • Talking less than usual
59
Q

5 ways to approach communication with someone with dementia

A
  • Learn about dementia, its progression, and its impacts on all
  • Believe that communication is possible at all stages
  • Focus on the person’s abilities & skills
  • Reassure & be positive
  • Meet the person where they are & accept their new reality
60
Q

8 communication strategies with those with dementia

A
  • Always approach from the front
  • Position yourself at their eye level
  • Wait until the person looks at you before speaking
  • Listen to the feelings & needs behind the words
  • Talk about one thing at a time
  • Avoid saying “you can’t”
  • Avoid overwhelming questions
  • Be patient & avoid jumping in
61
Q

define alzheimer’s disease

A

progressive decline in all areas of cognitive functioning

62
Q

what is the most common form of dementia

A

alzheimer’s disease

63
Q

define Early-onset familial Alzheimer’s disease

A

occurs before the age of 65 and individual has a positive family history of Alzheimer;s for at least 3 generations → hereditary

64
Q

a mutation in of 3 of these genes places you at greater risk for alzheimers

A

PS1, PS2, amyloid precursor protein

65
Q

define Sporadic Alzheimer’s disease (“late onset”)

A

occurs after age 65 due to a combination of genes, environment, and lifestyle

66
Q

describe the 3 ApoEs (Apolipoprotiens) found most important to the development of alzheimers

A
  • ApoE2 → carrying 1 copy can reduce the risk
  • ApoE3 → shows no influence
  • ApoE4 →present in about 50% of those with “late onset”
67
Q

5 symptoms of alzheimer’s

A
  • impaired memory & learning (reported early)
  • Getting lost while driving (reported early)
  • Impairments in attention, reasoning, judgment, problem solving, language abilities, and visual perception
  • Increasing difficulty with daily tasks
  • Inappropriate social behavior & changes in personality
68
Q

describe the 3 stages of alzheimers

A

mild stage: usually stay independent but may need help with certain activities to stay safe

moderate stage: diffculty communicating & performing daily tasks, behavioral & personality changes, often the longest stage

severe stage: most likely need full-time care, communication is very impaired, aggression & agitation is common, difficulty drinking & eating which can cause infection & death

69
Q

what are some brain changes for alzheiemrs

A
  • atrophy: decrease in size of an organ/tissue
  • amyloid plaques: abnormal deposits that form outside the neuron
  • Neurofibrillary tangles: tau components that collapse into twisted strands and occur inside the neuron → causes the inability of nutrients to move through the neuron, causing death of the neuron
70
Q

describe the formation of amyloid plaques

A

Amyloid precursor protein (APP): protein that remains both inside and outside of the neuron, and the part that remains outside gets cut off by secretases (enzymes… see below)

Alpha-secretase: normally, cuts off the APP that remains outside the cell that has the potential to become beta-amyloid

Beta-secretase: in Alzheimer’s, cuts APP off in the wrong place which causes beta-amyloid (sticky substance) to form, which produces plaques that cannot dissolve

71
Q

define tau

A

a protein that helps maintain the stability of microtubules which keep the parallel strands straight (of the neuronal transit system)

72
Q

3 biomarkers for alzheimers

A
  • Progressive atrophy of the brain → could be seen using CT scans
  • Distribution of tangles → could be seen using PET imaging
  • Predictions based on biomarkers show that these abnormalities come before the onset of clinical symptoms by at least 2 decades
73
Q

risk factors for alzheimers (decrease and increase)

A

increases:
–> strong:
- traumatic brain injury
- mid-life obesity
- mid-life hypertension
- smoking
- diabetes
–> possibly linked:
- history of depression
- sleep issues
–> unclear:
- hyperlipidemia

decreases:
–> strong:
- higher education
- physical activity
–> moderately linked:
- mediterranean diet
- cognitive training
–> possibly linked:
- moderate alcohol consumption
–> unclear:
- social engagement

74
Q

define parkinson’s

A

chronic & progressive disorder of the nervous system that affects movement → no known case & no cure

75
Q

symptoms of parkinson’s

A
  • Tremors of the hands, arms, legs, jaw, & face
  • Slowness of movement
  • Rigidity or stiffness of the limbs & trunk
  • Impaired balance & coordination
76
Q

how many canadians living with a form of dementia? how many are women?

A

500,000 canadian

2/3 are women

77
Q

FTD accounts for ___% of all dementias

A

5-10%

78
Q

what is the FTD survival rate from symptom onset

A

6-11 years

79
Q

what is the prevalence rate of lewy body dementia

A

0.1-5%

80
Q

average life expectancy of general alzheimers after diagnosis

A

about 8 - 10 years

81
Q

how many people in canada have general Alzheimer? over age 65? over age 85?

A

over 65 = 1 in 20
over 85 = 1 in 4

82
Q

why could mostly women have alzheimers

A

loss of estrogen during menopause & societal factors

83
Q

prevalence rate for early onset alzheimers

A

less than 1-5% of all cases

84
Q

what are the sex difference for MCI

A

more research is needed

85
Q

prevalence rates for vascular dementia

A

15-20% of all cases

86
Q

how many peopple in canda have parkinsons 18+? 65+?

A

55,000 aged 18+
79% age 65+

87
Q

3 treatment issues related to neurocognitive disorders

A

Cognitive enhancers: acetylcholinesterase inhibitors (AChEls) –> no significant effects found

memory training–> gains are made initially but not retained over time

Behavioral & Psychological Symptoms of Dementia (BPSD)
–> Agitation & aggression are most common & distressing examples
Disinhibition, apathy, & psychosis are also examples

88
Q

define informal caregiving

A

by a family member/friend who provides unpaid care for a loved one who is living with a disability/illness

account fro 80% of care

89
Q

examples of informal caregiving

A

Providing transport, house work, scheduling appointments, managing finances, personal care, medical treatments, etc

90
Q

define caregiving burden

A

the negative aspects of caregiving

91
Q

3 types of stigma for those with alzheimers

A

Self-stigma: internalizing illness stereotypes & formulating prejudice and discrimination against oneself

Structural stigma: the quality of healthcare services & inadequate behavior of professionals

Stigma by association: the emotions & beliefs of those closest to the stigmatized person (family, friends, etc)

92
Q

8 red flags that driving may be unsafe for those with dementia

A
  • Unaware of driving eros
  • Getting lost or confused while drivings
  • Trouble navigating turns
  • Difficulty staying in lane
  • Missing traffic signs
  • Unable to keep up with traffic speed
  • Getting honked at
  • Scrapes on the car/garage
93
Q

define traits

A

an individual’s usual characteristic way of behaving, thinking, and feeling

94
Q

3 ways personality traits are measures

A

Mean-level change: measured by comparing mean levels of a personality trait (ex. Measuring neuroticism between 2 or more points in time)

Rank-order consistency: measures the stability of an individual’s rank-order within a certain group over time

Intra-individual change: measuring personality change at the individual level

95
Q

define maturity principle

A

people become more agreeable & emotionally stable, more conscientious, and less neurotic with age

96
Q

big 5 traits & descriptions

A

Openness to Experience
Original, imaginative, creative, curious, daring, artistic, independent

Conscientiousness
Careful, reliable, hard-working, ambitious, well-organized, energetic, persevering

Extraversion
Sociable, fun-loving, affectionate, friendly, passionate, active

Agreeableness
Good-natured, soft-hearted, courteous, selfless, easy going, forgiving

Neuroticism
Fearful, angry, anxious, insecure, moody, jealous, self-conscious

97
Q

which traits have the widest gap between women and men for those in the middle age category (70-79)

A

Openness and neuroticism:

98
Q

describe the agreeableness trend among women and men

A

women score higher than men, but the gap begins to close in the middle-age category (70-79) and completely close in the oldest-old (80-92)

Adult Development & Aging (2 decks)

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