Late life and neurocognitive Disorders

when it comes to cognitive decline, it was actually found that as a person age:

severe cognitive problems actually do not occur for most

It was actually found that older adults were not unhappy but rather they are __________, which means they display less psychophysiological response to negative emotion

more skilled at emotion regulation

Hence, adults tend to pay attention to _________ stimuli

positive

It was found that older adults aren't actually lonely. Rather, the theory of __________states that interests shift away from seeking new social interactions and to cultivating a few close relationships instead

Social selectivity

These are common problems experienced in late life:

-physical decline and disabilities

-sensory acuity deficits

-loss of loved ones

-social stress of stigmatizing attitudes towards elderly

-cumulative effects of lifetime of stressors

-decline in quality and depth of sleep

This is the prescription of multiple drugs to a person

polypharmacy

in researches that look into the lives of elderly people, this type of effect is caused by a being a certain age

age effects

in researches that look into the lives of elderly people, this type of effect is caused by having grown up during a particular time period

cohort effects

in researches that look into the lives of elderly people, this type of effect is caused by testing people at a particular time in history

time-of-measurement effects

this type of research design compares different age groups at the same point in time on variable of interest

cross sectional studies

what is the disadvantage of cross sectional studies?

it fails to provide information about how people actually change over time

this type of research design involves researchers retesting the same group of people with same measures at different points in time

longitudinal studies

what is the disadvantages of longitudinal studies?

attrition can lead to a biased sample

what is this type of attrition where the participant is no longer available for follow-up because they died

selective mortality

age related deterioration in the _______ can account for panic symptoms in late life

vestibular system

depression is actually common after ________ or _______ happen

strokes; heart attacks

When it comes to the prevalence of psychological disorders, it was found that in the elderly

they were less common than in younger adults

why is it that psychological disorders are less common in the elderly population?

-more positive emotionally

-more close-knit social circles

-may grow out of those symptoms

-methodological issues lead to underestimation of prevalence

-most don't get newly diagnosed but rather experience continuation of symptoms that began earlier

the methodological issues which lead to underestimation of prevalence in late life are:

-discomfort discussing symptoms (response bias)

-cohort effects

-psychological disorders associated with premature mortality (selective mortality)

This disorder involves the significant deterioration of cognitive abilities causing impairment. its most common symptom is diminished memory and it develops slowly over period of years.

Dementia

This disorder involves early signs of decline before functional impairment. This involves modest cognitive declines in 1 or more domains. The cognitive deficits do not interfere with everyday activities, but greater effort may be required to maintain independence.

Mild cognitive impairment

Why is it problematic that DSM5 criteria for Mild cognitive impairment is only asking for a low score on only one cognitive test?

current criteria may not be very reliable since it is only asking for one test. Some cognitive tests are more reliable than others, hence using more than one test improve reliability

True or False

In MCI, it is important that cognitive deficits do not occur exclusively in the context of delirium and are not due to another psychological disorder

True

When looking at the prevalence of dementia before the age of 65, it is only ________%

less than 2%

What are the different forms of dementia?

-alzheimer's disease

-frontotemporal dementia

-vascular dementia

-lewy body dementia -huntington's disease

This form of dementia involves irreversible brain tissue deterioration. The person has absentmindedness and gaps in memory for new material. They often leave tasks unfinished or forgotten. They may experience apathy, depression, and disorientation

Alzheimer's disease

excess of this protein causes Alzheimer's disease. This is made out of beta-amyloid protein deposits, which is primarily found in the frontal cortex.

Plaques

Excess of this protein causes alzheimer's disease. This is made out of protein filaments composed of tau. it is primarily found in the hippocampus

Neurofibrillary tangles

what happens in the brain during the early stages of alzheimer's?

there is a loss of synapses for acetylcholinergy and glutamatergic neurons. Neurons also begin to die.

What is the shrinking sequence of the different brain parts in Alzheimers?

etorhinal cortex>hippocampus>cerebral cortex>frontal, temporal, parietal

which brain parts are least affected during the shrinking?

cerebellum, spinal cord, and motor and sensory areas of cortex

heritability estimates for late onset Alzheimers range from

0.60-0.80

__ specific genetic loci was identified in Alzheimers

19

When looking at its genetic factors, it was found that people with Alzheimers have a polymorphism of a gene on chromosome 19, which is called __________. This allele is implicated in the overproduction of beta-amyloid plaques, loss of neurons in the hippocampus, and low glucose metabolism in several regions of the cerebral cortex

Apolipoprotein e4 or ApoE-4 allele

People who have greater risk to get Alzheimers usually experience

social isolation and insomnia

Lower risk for alzheimers is associated with

fish consumption, mediterranean diet, education, and exercise, and engagement in cognitive activities (46% decrease in risk)

________ protects against expression of underlying neurobiological disease

intellectual activity

__________ states that people may be able to compensate for the disease by using alternative brain networks or cognitive strategies

cognitive reserve

This form of dementia involves loss of neurons in frontal or temporal lobes.

Frontotemporal dementia

True or False

Unlike alzheimer's, memory is not severely impaired in Frontotemporal dementia

true

the most common subtype for frontotemporal dementia is

behavioral variant

The behavioral variant of frontotemporal dementia involves deterioration in:

empathy, executive function, ability to inhibit behavior, compulsive and perseverative behaviors, tendencies to put nonfood in mouth, apathy

What are the possible causes of frontotemporal dementia?

-pick's disease

-high levels of Tau

-strong genetic component

This form of dementia is caused by cerebrovascular diseases such as strokes. This may be caused by old age, high levels of "bad" cholesterol, smoking, and high BP. Its symptoms depend on the location of the stroke.

Vascular Dementia

This form of dementia involves protein deposits form in the brain which causes cognitive decline. It may involve prominent visual hallucinations, fluctuating cognitive symptoms, sensitivity to physical side effects of antipsychotic medications, intense dreams involving movement, vocalizing

Lewy body dementia/ dementia with lewy bodies

DLB is usually hard to distiguish from _____ and ____ diseases

Parkinson's; Alzheimer's

medications used for dementia are

cholinesterase inhibitors (drugs interfering with breakdown of acetylcholine) like donepezil (Aricept), reviastigmine (Exelon), and memantine (Namenda)

True or False

medications for dementia can only slow decline but cannot restore functioning

true

This treatment of dementia involves education about the disease and care for the patient and family

supportive psychotherapy

This group of treatments of dementia involves different memory aids, music to reduce agitation, behavioral activation, and teaching communication strategies.

Behavioral approaches

This disorder involves clouded state of consciousness. The person may have extreme trouble of focusing attention, inability to maintain coherent stream of thought, disturbances in sleep/wake cycle, vivid nightmares and dreams, disorientation of time, place and name, perceptual disturbances, and memory impairment.

Delirium

True or False

Changes in cognition for Delirium needs not to be accounted for by dementia

True

Onset of delirium is characterized to be ______ and it fluctuates during the course of a day

rapid

Symptoms of Delirium are caused by______

an underlying medical condition, substance intoxication, withdrawal, or toxin

Delirium can occur at any age but it is most common in

children and elderly

If left untreated, mortality rate of delirium becomes ______ and it has an increased risk of further cognitive decline

high

Delirium is best treated when _________, which can lead to complete recovery

underlying cause is treated

medications used to treat delirium is

atypical antipsychotics

it takes ______ weeks to clear symptoms of delirium

1-4

The following needs to be reduced since they are risk factors for delirium:

sleep deprivation, immobility, dehydration, visual and hearing impairment

This form of dementia is a neurocognitive disorder involving memory problems, and similar symptoms also seen in Alzheimer's disease. However, it also involves involuntary jerky or writhing movements and muscle rigidity.

Huntington's disease

_______ is defined by involuntary jerky or writhing movements and problems with voluntary movements due to muscle rigidity or contractions

Chorea

What is the main cause of Huntington's disease?

it is an autosomal dominant disorder caused by a defect in a single gene

True or False

A person only needs 1 copy of the defective gene to develop Huntington's disease

true

Huntington's disease often first appear during ages _____

30-40s