Week 11- Cognitive Changes Flashcards
PART 1
PART 1
What are the 6 cognitive domains?
- Complex Attention
- Social Cognition
- Learning/Memory
- Language
- Perceptual Motor Function
- Executive Function
What are the (3) types of memory?
- Sensory Memory
- Short-term Memory (STM)
- Long-term Memory (LTM)
Sensory Memory:
- What are the (3) subtypes?
- What is it?
- What part of the brain controls it?
- Iconic (visual), Echoic (auditory), Haptic (touch)
- Input from the 5 senses, can be ignored or perceived and transferred to STM in <1s.
- Initial input to SENSORY AREAS of brain, then processed by HIPPOCAMPUS.
STM:
- Limited capacity with temporal recall, processed in __-__s.
- What part of the brain controls it?
- 10-15s
- Prefrontal Cortex
LTM:
- What are the (3) subtypes? Explain each.
- What part of the brain controls each subtype?
Implicit (procedural):
- Subconscious influence of previously encountered information on subsequent performance.
- Cerebellum, putamen, caudate nucleus, motor cortex
Explicit (declarative) Semantic:
- Structured facts, meanings, concepts, and knowledge.
- Prefrontal cortex, temporal cortex
Explicit (declarative) Episodic:
- Autobiographical of events, contextual knowledge, and associated emotions.
- Hippocampus
Which of the types of memories remain stable with age, and which have a gradual decline?
Stable
- Sensory Memory
- STM
- LTM Implicit (procedural)
Gradual Decline
- LTM Explicit (declarative) Semantic
- LTM Explicit (declarative) Episodic
How is Delirium different from Dementia?
- Delirium typically has a rapid onset (hrs-days) and is a sign of an underlying condition in older adults.
- Delirium is short in duration and typically resolves once the underlying condition has been addressed.
-Dementia is more gradual in onset (weeks-months-years) and is not caused by a different condition.
What are the (3) types of Delirium?
- Hyperactive
- Hypoactive
- Mixed
What are some pathophysiology’s behind Delirium? (4)
- Brain structural changes
- NT disturbance in central cholinergic/adrenergic pathways
- elevated inflammatory cytokines
- multifactorial in older adults
Delirium is associated with increase in what (4) things?
- Increased LOS
- Increased recovery times
- Increased institutionalized care
- Increased morbidity/mortality
Delirium Prevention and Management:
- ___-___% of cases are preventable.
- Determine cause and remediate ASAP.
- What are some drugs linked to Delirium? (3)
- Cognitive orientation, early mobility, enabling adequate hearing and vision, promoting a normal sleep-wake cycle, and proper nutrition/hydration are all __________ interventions to treat Delirium.
- 30-40%
- psychoactive agents, narcotics, anticholinergics
- nonpharmacological
“A clinical syndrome of cognitive and functional decline, usually of a chronic or progressive nature.”
Dementia
Dementia is a global impairment impacting intellectual functioning, memory, and at least one of what (5) things?
- ) Abstract thinking
- ) Judgment and language
- ) Identification of people and objects
- ) Personality changes
- ) Ability to use object appropriately
What are the (4) main types of Dementia?
- Alzheimer’s Disease (AD)
- Vascular Dementia (VD)
- Dementia with Lewy Bodies (DLB)
- Frontotemporal Dementia (FTD)
- SCI = _________ cognitive impairment
- MCI = ________ cognitive impairment
- What is the difference between amnestic and nonamnestic cognitive impairment?
- SCI = Subjective Cognitive Impairment
- MCI = Mild Cognitive Impairment
- Amnestic (memory is primary loss), Nonamnestic (other areas more affected than memory)
Vascular Dementia:
- ___-___% of cases.
- What areas of the brain are affected?
- Associated with ____ Disease and is more often ________ onset.
- Is memory loss usually more or less severe than AD?
- Can occur in conjunction with AD, what is this called?
- 20-30%
- medial temporal atrophy, cortical and subcortical lesions
- CV Disease, abrupt
- Less severe
- mixed dementia
Vascular Dementia S/Sx. (3)
- Impaired attention, planning
- Difficulties with complex activities
- Disorganized thought
Dementia with Lewy Bodies:
- ___% of cases, accepted to be highly _________/________.
- What areas of the brain are affected?
- Key features includes complex visual _________, __________, _______ disturbances, autonomic symptoms, and fluctuating ________.
- Can occur in conjunction with AD, what is this called?
- 8%, highly misdiagnosed/underdiagnosed
- less severe medial temporal lobe atrophy than AD, limbic, brainstem, neocortex
- complex visual hallucinations, Parkinsonism, sleep disturbances, autonomic symptoms, and fluctuating cognition
- mixed dementia
Frontotemporal Dementia:
- ___-___% of cases.
- What areas of the brain are affected?
- Is it more common in older or younger groups?
- Is memory intact in early stage?
- Significant changes in behavior/personality.
- _________/_________ are common.
- What are the (3) types of FTD?
- 3-10%
- frontal and temporal lobes (depend on type of FTD)
- younger
- Yes, memory intact early
- Disinhibition/impulsiveness
- Pick’s Disease, Progressive Supranuclear Palsy, Corticobasal Degeneration
Alzheimer’s Disease:
- ___-___% of cases.
- What areas of the brain are affected?
- ______ loss of memory and function leading to total dependence on caregivers.
- Eventual inability to _______ friends/family.
- 50-60%
- gradual
- recognize friends/family
Neurobiological Changes of Cognitive Dysfunction:
- _________ changes occur years before symptoms appear in AD and other Dementias.
- In the asymptomatic to mild cognitive impairment stages, what is the most prominent change?
- neurobiological
- amyloid markers
Amyloid beta is present throughout the lifespan in humans and found in all vertebrae. What are some beneficial roles of amyloid beta? (5)
- Antimicrobial activity
- Tumor suppression
- Sealing leaks in the BBB
- Promoting recovery from brain injury
- Regulating synaptic function
What appears to be the driving force behind AD?
Amyloid beta
