Unit 3| Cognitive impairment and dementia Flashcards
What is the primary focus of this presentation?
The presentation focuses on cognitive impairment and dementia, including normal cognitive aging, mild cognitive impairment (MCI), major neurocognitive disorders, and superaging.
What are the main topics covered in this presentation?
The presentation covers normal cognitive aging, mild cognitive impairment, dementia (major neurocognitive disorder), and superaging.
What does cognitive aging refer to?
Cognitive aging refers to the changes in cognitive function that occur naturally as people age.
How does normal cognitive aging differ from pathological cognitive decline?
Normal cognitive aging does not impair daily living but may involve subtle declines in functional tasks like driving. Pathological cognitive decline includes conditions such as MCI and dementias.
What are the two types of intelligence affected by aging?
Crystalized intelligence (overlearned knowledge such as vocabulary and semantic knowledge) remains stable, whereas fluid intelligence (problem-solving, reasoning, attention, memory) declines with age.
What is semantic memory?
a type of long-term memory that stores general knowledge about the world, such as facts, concepts, and meanings of words—things you “know” but don’t necessarily remember learning.
What are the key changes in processing speed and memory with aging?
Processing speed decreases, affecting information intake and response time. Memory issues arise due to reduced processing speed, selective attention, and strategy use.
How does attention change with age?
Aging affects readiness, shifting attention focus, and selective attention during tasks.
How do language and visuospatial abilities change with age?
Language fluency and naming ability decline after 70 years. Visuospatial abilities, including recognition and object location, also diminish.
What is language fluency?
the ability to speak, understand, read, and write a language easily and smoothly, without much effort or hesitation.
What executive functions are affected by aging
Aging impacts concept formation, abstract reasoning, mental flexibility, inhibition, and verbal reasoning.
What are the main structural changes in the aging brain?
Gray matter volume declines, particularly in the prefrontal cortex and hippocampus. White matter loss is greater than gray matter loss and affects memory and executive function.
What factors influence cognitive aging?
Genetics (60%), medical and psychological conditions, sensory deficits, and environmental factors such as an active lifestyle.
What is cognitive reserve?
Cognitive reserve refers to factors that help delay or minimize cognitive decline, including education, social participation, and engaging in complex activities.
What activities are associated with better cognitive aging?
Intellectual activities (reading, puzzles), physical activities (dancing, gardening), and social engagement (travel, cultural events, socializing).
What is mild cognitive impairment (MCI)?
MCI involves noticeable cognitive decline without significant impact on daily living.
How is MCI diagnosed?
MCI diagnosis includes self-reported concerns, impairment in cognitive domains, and preserved independence in daily activities.
What are common symptoms of MCI?
Difficulty with complex tasks, mild memory problems, distractibility, and reliance on lists.
What are the DSM-V criteria for MCI?
Minor cognitive decline in at least one domain, shown by objective assessment, but not severe enough to interfere with independence.
What is dementia?
Dementia is a chronic syndrome marked by cognitive decline that interferes with daily function.
What are the impacts of dementia?
Dementia affects memory, executive function, language, and behavior, impacting independence and quality of life.
What are the general criteria for dementia syndromes?
A decline in two or more cognitive domains that significantly interfere with daily functioning.
What are the main types of dementia?
- Alzheimer’s Disease (AD): Progressive memory loss, beta-amyloid plaques, and tau tangles.
- Vascular Dementia (VaD): Caused by strokes or vascular disease.
- Lewy Body Dementia (LBD): Cognitive fluctuations, hallucinations, and Parkinsonian features.
- Frontotemporal Dementia (FTD): Affects behavior, social cognition, and language.
How common is dementia?
Around 50 million people worldwide suffer from dementia, with approximately 10 million new cases reported each year.
What is the most common cause of dementia?
Alzheimer’s disease is the leading cause, accounting for 60-70% of dementia cases.
What are some other causes of dementia besides Alzheimer’s disease?
Dementia can also result from various diseases and injuries affecting the brain, such as stroke (vascular dementia) and other neurodegenerative conditions.
What is a key characteristic of dementia syndromes?
Dementia involves a decline from a previously higher level of cognitive function.
How many cognitive domains must be impaired for a dementia diagnosis?
There must be impairment in at least two or more cognitive domains.
How do cognitive deficits impact daily life in dementia?
The deficits are severe enough to interfere with normal daily functioning and lead to dependence on instrumental activities of daily living (e.g., managing finances, medication, or household tasks).
Can dementia be mistaken for other mental health disorders?
No, the cognitive deficits in dementia are not due to delirium or Axis I disorders such as depression or schizophrenia.
What is the primary criterion for diagnosing dementia according to DSM-5?
There must be a significant cognitive decline from a previous level of performance in at least one or more cognitive domains.
What cognitive domains are assessed in dementia diagnosis?
The domains include complex attention, executive ability, learning and memory, language, visual constructional-perceptual ability, and social cognition.
How is cognitive decline identified?
Cognitive decline is determined through:
a) Self-report, reports from a knowledgeable informant, or clinical observation.
b) Objective assessment, showing performance below the 2.5th percentile or < -2 standard deviations.
How do cognitive deficits affect daily life?
The deficits are severe enough to interfere with independence, requiring assistance with instrumental activities of daily living (e.g., managing finances, medications, or household tasks).
What are the main categories of dementia classification?
Dementia is classified into cortical, subcortical, and mixed types.
What are the key features of cortical dementias?
Cortical dementias primarily affect higher cognitive functions, including:
- Learning and episodic memory
- Severe language deficits
- Visuospatial skills (e.g., navigation and orientation)
- Executive function
How do subcortical dementias differ from cortical dementias?
Subcortical dementias mainly affect motor and cognitive processing speed, with features such as:
- Motor dysfunction
- Slowness of thought
- Prominent deficits in executive function and attention
- Visuoperceptual and constructional difficulties (e.g., apraxia)
- Mild to moderate impairment in memory and language –> Vascular dementia
What are examples of mixed dementias?
Mixed dementias include:
- Lewy Body Disease (combining features of both cortical and subcortical dementia)
- Frontotemporal Dementia (affecting behavior, personality, and language)
