Nauropsych Topic 3

physical wellbeing assessments include

sensory and physical changes; neurological disorders; comorbidities; medication effects; cognitive changes

mental wellbeing assessments include

psychological conditions; grief and loss or emotional issues; changes in roles; social relationships

other aspetcs of assessments include

attitudes to ageing; impact on decision making capacity; autonomy and independence; role of family; elder abuse; palliative or end of life care issues

symtpoms of anxiety and depression in older adults

mostly cognitive symptoms

risk factors for depression and anxiety in older adults

disability; medical issues; poor health; prior depression; bereavement; abuse in childhood

protective factors for depression and anxiety in later life

social support; physical exercise; higher education

biologival explanations of age-related memory decline

we lose 2% of our brain volume each decade, which results in reduced myelination and neuron connection and therefore bloodflow to the PFC resulting in poorer attention and memory, and sensory changes

social cognitive explanations of age-related memory decline

negative age stereotypes; worry about the casue of memory lapses; reduced routine and habit

how negative stereotypes impact age-related memory decline

expectations of poor memory leads to decreased use of active strategies and therefore poorer recall

ways to minimise memory changes

changeing expectations of growing older and optimising memory through improving understanding of how memory works and creating realistic expectations

normal age related decline occurs in

episodic, source, working memory; extending from changed in the PFC and hippocampus

non age related declines may occur in

semantic, implicit, procedural, and naturalistic prospective memory

syndrome

a pattern of symptoms that can be caused by many different illnesses

dementia syndrome

a gradual and persistent progressive decline in memory and other intellectual abilities that produces multiple cognitive impairments

causes of dementia

alzheimers, vascular dementia, frontotemportal dementia, MND, huntingtons, parkinsons and dementia with lewy bodies

criteria for dementia

behavioural symptoms that interfere with function in work and personal activities; represents a decline from previous levels; are not due to delirium or psychiatric disorder

cognitive behavioural impairments related to dementia

new learning and memory, reasoning and judgement, visuospatial abilities, language, changes in personality and behaviour

criteria for alzheimers disease dementia (AD)

insideous onset; progressive; initial and prominent cogniitve deficits; absence of evidence for other cause of condition

amnesiac AD presentation

deficit for learning and recall of new information

non-amnesiac AD presentation

deficit for language, visuospatial, and executive function

reduced acquisition

a symptom of AD where there is an associated flattened learning curve, reduced primary affect, and poor utilisation of semantic cues

temporal memory gradient

a symptom of AD where there is better recognition for events that occurred in the distant past

logogenic primary progressive aphasia

associated with impaired word finding and sentence repetition but spared semantic and motor speech

posterior cortical atrophy

associated with initial visual and posterior cognitive impairments including visuospatial and visual perceptual disorders, alexia, and gertsmans and baliant syndromes

behavioural ad dysexecutive variants of AD

associated with predominantly behavioural features including apathy and disibhibition, and executive dysfunction

primary progressive aphasia

associated with neural atrophy in the frontal and temporal lobes that produces impaired language production and comprehension but good performance on other cognitive tasks

5 stages of dementia

cdr0/no impairment; cdr0.5/questionable impairment; cdr1/mildimpairment; cdr2/moderate impairment;cdr3/severe impairment

cdr 0 or no impairment

no memory problems, full orientation to time and place, normal judgement, good functioning in everyday life, well maintained home, personal needs met

cdr 0.5 or questionable impairment

slight memory impairment, difficulty solving challenging problems, home is well maintained and personal needs are met

cdr 1 or mild impairment

noticable mild cognitive impairments, memory loss for recent events, disorientation to time and place, difficulty functioning independently outside the home, housework neglected but personal needs met

cdr 2 or moderate impairment

recent memory and new learning significantly impairred, disorientation to time and place, assistance required for social engagement, hygiene, and housework

cdr 3 or severe impairment

lack recognition of loved ones, disorientation to time and place, assistance required in all aspects of functioning, activities outside the home significantly limited

mild cognitive impairment

characterised by subjective cognitive concerns and objective impairments on tests

difference between MCI and dementia

dementia involves impairment in multiple cognitive domains and significant interference with daily living

difference between depression and alzheimers in older people

depression is associated wth more acute onset, concerns out of roportion to actual cognitive performance, dysphoric mood and low ses

cognitive profile of depression in older people

difficulty with effortful processing; diminished effort; reduced processing speed, attention, executive function, and memory retrieval

LaTCH

a memory management group intervention that involves a manualised 6 week, 2 hour group for middle aged participants

content of LaTCH

common everyday memory concerns, understanding memory, preparing for remembering, reduced memory load, specific internal strategies that work

vascular dementia criteria

evidenced by at least one of the following: dementia onset within 3 months of stroke; abrupt deterioration in cognition; fluctuating progression of cognitive deficits

criteria for vascular cognitive disorders

establishment of cognitive disorders; determination of vascular disease being the dominant cause of the cognitive deficits

demential with lewy bodies (DLB) criteria

variations in alertness and attention, recurrent visual hallucinations, REM sleep behaviour disorder, Parkinson’s symptoms

parkinson’s dementia disease (PDD)

demential co-occurring in the context of well-established Parkinson’s disease

symptoms of PDD

tremor at rest; postural disturbance; cognitive dysfunction; emotional changes including apathy and depression

postural disturbance of PDD

head bowed, shoulders dropped, shuffling gait, small steps, poor balance

cognitive dysfunction associated with PDD

poorer attention and concentration, executive function, visuopsatial processing, and memory retrieval

neuropsychology of DLB

associated with deficits in attention, executive function, and visuospatoal abilities