Chapter 17: Aging and Cognition Flashcards
(43 cards)
two groups of psych problems of older adults
- disorders COMMON in people of all ages but are not connected to the process of aging
- depression, anxiety, SUD - disorders of cognition that RESULT FROM BRAIN IRREGULARITIES
- delirium, mild neurocognitive disorders, major neurocognitive disorders
older adults (ages)
65-70 and older
depression in later life
- common
- assessment can be hard b/c they don’t like to talk about feelings (generational thing)
- p rate: 20%
- higher among women, people 85+, and people living in nursing homes
___% of old people display bipolar disorder?
1%
predictors of depression in the elderly
- Hx of depression
- poor health
- disability
- insomnia
- loss
- low social support
is suicidality a concern in older adults?
yes
old people kill themselves more (not just attempts, but actually committing suicide)
___% of older adults commit suicide
25%
depression Tx
CBT
interpersonal therapy
antidepressants
risk of antidepressants in older adults
they require different meds/doses because their metabolization changes
higher risk of causing cog impairments
anxiety in later life
- common
- p rate: 10%
- lifetime p rate: 7%
common Tx:
- CBT
- psychotropic meds (risk: may cause cog impairments)
disorders of cognition
leading Dx:
delirium, mild neurocognitive disorder, major neurocognitive disorder
** most common neurocog disorder is Alzheimer’s
** the cause of forgetting IS physiologically/neurologically based
delirium (aka clouding of consciousness)
a state of massive confusion over a short period of time (difficulty concentrating, focusing, and thinking sequentially)
**reversible if treated
- 18-35% of elderly in hospitals (for general medical issue) have Sx of delirium
delirium (p rates)
nonelderly pop: less than 0.5%
people over 55: 1%
people over 85: 14%
causes of delirium
fever, certain diseases and infections (e.g. UTI/bladder infections), poor nutrition, head injuries, strokes, stress, and intoxication
Sx of delirium
disoriented
hallucinations (visual)
lack of concentration
lack of attention
neurocognitive disorders
cog. mishaps are normal with aging, BUT some people experience memory and/or other cog issues that are more extensive and problematic (resulting in mild/major neurocog disorder)
- may also have changes in behav or personality
- can be caused by nutritional or metabolic problems
e.g. word-finding problems (not normal ‘tip of the tongue’ but genuinely doesn’t know it)
when can neurocog disorders be officially Dx
after death to see the extent of brain damage
what is dementia
global deterioration of mental functioning (memory is always impaired), other areas may include:
- attention, language, mood, self-care, reasoning and judgment, visual-spatial abilities, and physical function
what is the most common neurocog disorder
Alzheimer’s
2/3 of all cases of dementia or neurocog disorder
major neurocog disorder
decline in cog function is SUBSTANTIAL, interfering with one’s ability to be independent
mild neurocog disorder
decline in cog function is MODEST and does NOT interfere with one’s ability to be independent
onset of Alzheimer’s
- early onset/familial (before 65)
- has a clear set of genetics - late onset/sporadic (after 65)
- combo of genetics, lifestyle, and environmental factors
only 10% of cases are early onset
avg time between onset and death is 4-8 years (some can survive for up to 20 years)
Alzheimer’s
usually begins with mild memory problems, lapses of attention, and difficulties in language/communications
**struggles to differentiate between day/night
physical markers of Alzheimer’s
- EXCESSIVE amyloid/senile plaques
- sphere-shaped deposits of beta-amyloid protein that form in spaces between cells in the hippocampus, cerebral cortex, and other brain regions/vessels - EXCESSIVE neurofibrillary tangles
- twisted tau protein fibers found within cells of the hippocampus
ALSO the NTs:
acetylcholine and glutamate
are low in supply and there are IRREGULARITIES IN BREAKDOWN OF CALCIUM
