Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

special pops > cog issues in older adult > Flashcards

cog issues in older adult Flashcards

1
Q

Types of Memory

A
  1. Sensory
  2. Short Term
  3. Long Term
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of sensory memory

A
  1. iconic (visual)
  2. echoic (auditory)
  3. haptic (touch)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of short term memory

A

working

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Types of long term memory

A
  1. implicit (procedural)
  2. explicit
    - declarative semantic
    - declarative episodic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

differences between delerium and dementia

A
  1. delerium short term, demtentia long term
    2.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

delirium or dementia:
long term

A

dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

delirium or dementia:
caused by medication, anesthesia, or encephalopathy

A

delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

delirium or dementia:
caused by degeneration in the brain

A

dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

delirium or dementia:
one of the 1st symptoms of UTI in elderly

A

delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What % of gen med is affected by delerium?

A

wide range
2-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the types of delirium?

A
  1. hyperactive
  2. hypoactive
  3. mixed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In regards to hospitalization, delrium is associated with:

A
  • increased length of stay
  • prolonged recovery times
  • institutionalized care
  • increased morbidity and mortality rates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Delirium pathophysiology

A
  • Brain structural changes
  • neurotransmitter disturbance in cholinergic/adrenergic pathways
  • elevated inflammatory cytokines
    • multifactorial in older adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

at least _% of delerium cases are preventable

A

30-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Prevention and management of delerium

A
  • determine cause and remediate ASAP
  • ID drugs linked to delirium
    • nonpharmacologic interventions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drugs linked to delirium

A
  • psychoactive agents
  • narcotics
    • anticholinergics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

delirium: nonpharmacologic interventions

A
  • cog orientation
  • early mobility
  • enabling adequate hearing and vision
  • promote normal sleep-wake cycle
    • proper nutrition/hydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

dementia: a global impairment impacting intellectual functioning, memory, and at least one of the following:

A
  • abstract thinking
  • judgement and language
  • ID of people/objects
  • personality changes
    • ability to use object appropriately
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

types of dementia

A
  • AD
  • vascular dementia
  • dementia w/lewy bodies
  • frontotemporal dementia
    • mixed pathologies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Levels of cog impairment

A
  • subjective cog impairment
  • mixed
  • moderate
  • severe
    • Amnestic vs Nonamnestic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Vascular dementia accounts for _ % of dementia cases

A

accounts for 20-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

vascular dementia key features

A
  • cerebrovascular disease
  • usually abrupt
  • less severe memory loss than AD
    • can occur w/AD (mixed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

vascular dementia:
affected brain areas

A
  1. medial temporal atrophy
    1. cortical and subcortical lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

vascular dementia:
clinical symptoms

A
  • impaired attention/planning
  • difficulty w/complex activities
    • disorganized thoughts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Dementia w/Lewy Bodies accounts for _% of dementia cases

A

8%

accepted to be highly underdiagnosed or misdiagnosed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lewy Body Dementia:
Key Features

A
  • complex visual hallucinations
  • parkinsonism
  • sleep disturbances
  • autonomic symptoms
  • fluctuating cog
    • can occur w/PD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Lewy Body Dementia:

affected brain areas

A
  • medial temporal lobe (less severe than AD)
  • occipital hypoperfusion and hypometabolism
  • loss of dopaminergic neurons in substantia nigra
  • limbic
  • brainstem
    • neocortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

LBD 3 primary presentations

A
  1. PDD
  2. dementia w/lewy bodies
    1. neuropsychiatric symptoms (leads to DLB)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Frontotemporal dementia accounts for _% of dementa

A

3-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

frontotemporal dementia:

key features

A
  • more common in 50-60 y.o.
  • memory often intact early stage
  • sig changes in behavior/personality
    • disinhibition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

types of frontotemporal dementia

A
  1. Pick’s disease
  2. progressive supranuclear palsy
  3. corticobasal degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

frontotemporal dementia:

affected brain areas

A
  • frontal lobe
  • temporal lobe

specific areas of atrophy depend on variant

33
Q

Alzheimer’s Disease accounts for _% of dementia cases

A

50-60%

34
Q

Alzheimer’s Disease:

key features

A
  • gradual loss of memory and function
  • eventually total dependence
    • eventual inability to recognize family/friends/self
35
Q

Alzheimer’s Disease:

diagnoses made through…

A
  • interview
  • history
    • diagnostic testing
36
Q

Alzheimer’s Disease:

affected areas

A
  • entorhinal area
  • hippocampus
  • amygdala
    • regions of neocortex
37
Q

Diagnostic Markers for AD

A

one of the three must be present:

  1. medial temporal atrophy
  2. temporoparietal hypometabolism
  3. abnormal neuronal CSF markers
38
Q

Less common forms of dementia

A
  • Creutzfeldt-Jakob disease
  • HIV related
  • Huntington’s
  • MS
  • Normal Pressure hydrocephalus
  • Niemann-Pick Disease Type C
38
Q

Less common forms of dementia

A
  • Creutzfeldt-Jakob disease
  • HIV related
  • Huntington’s
  • MS
  • Normal Pressure hydrocephalus
  • Niemann-Pick Disease Type C
39
Q

Anatomy features of Dementia

A
  • communication signals between brain cells diminish
  • metabolism impaired w/development of neurofibrillary tangles
  • repair disabled by amyloid plaques
    • plaques and tangles produce mistakes throughout brain = cell death
40
Q

Amyloid Beta beneficial roles

A
  • antimicrobial activity
  • tumor suppression
  • sealing leaks into BBB
  • promoting recovery from brain injury
    • regulating synaptic function
41
Q

relationship between plaque burden and dementia

A
  • cog symptoms linked more closely to #/location of tau tangles
  • post mortem: tangles in absence of plaques
    • in some cases: plaques are protective
42
Q

AD: drug trial results

A

“right drug but too late”

  • plaques can form decades before cog symptoms
  • beta amyloid levels may have plateaued by time patient enters trial
43
Q

APOE gene

A

highest risk for Alzheimer’s

  • APO2: rarest. 5-10% population (lower risk)
  • APO3: doesn’t increase or decrease risk. 7% pop
  • APO4: 15% of pop (higher risk)
44
Q

APOE4 affect on brain function

A
  • increased risk of dementia thought to be linked to toxic “gain of function”
  • normal healthy brain function appears to diminish (amyloid not cleared)
45
Q

APOE gene:

synthesized in liver to

A

transport lipids and maintain cholesterol homeostasis

46
Q

APOE gene:

synthesized in brain to regulate

A
  • level of Aβ
  • brain lipid transport
  • glucose metabolism
  • neuronal signaling
  • neuroinflammation
  • mitochondrial function
47
Q

APOE4 and Amyloid Beta

A

ApoE4 carriers have greater AB deposits than non carriers

  • lower APOE levels facilitates AB accumulation
  • APOE regulates levels of AB
  • impairs lysosomal degradation of AB, less transport of AB across BBB
48
Q

current drug treatment options for AD

A
  • neurotransmitter based
  • treat symptoms
    • delay progression
49
Q

emerging drug treatment for AD

A

disease modifying drugs

slow/prevent onset of disease

not yet effective

50
Q

AD Drug Options:
Neurotransmitter depletion

A
  • achetylcholine
  • neurotransmitters (serotonin, somatostatin, NE)
  • Symptomatic Trx
  • block acetylcholinesterase
  • target NMDA pathway
51
Q

QOL scale:
Mild dementia

A

schedule for evaluation of individual QOL

52
Q

QOL scales:

mild-mod dementia

A
  • cornell-brown scale
  • dementia QOL instrument
    • QOL AD scale
53
Q

QOL scales:
advanced dementia

A
  • dementia care mapping
  • qualidem and discomfort scale
54
Q

What is the #1 reason families turn to institutionalization

A

incontinence

55
Q

Zarit Burden Interview

A

Widely used measure of caregiver burden

  • 22 items behavioral and functional impairments
    • impact of caregiving on health, relationships, finances
56
Q

What level of the FAST indicates hospice support

A

level 7

57
Q

Tools to screen for cog loss

A
  • blessed orientation memory-concentration test
  • dementia screening indicator
  • functional activities questionnaire
  • geriatric depression scale
  • global deterioration scale
  • mini cog
  • MMSE
58
Q

7 stages of global deterioration

A
  1. no impairment
  2. very mild decline
  3. mild
  4. moderate
  5. moderately severe
  6. severe
  7. very severe
58
Q

7 stages of global deterioration

A
  1. no impairment
  2. very mild decline
  3. mild
  4. moderate
  5. moderately severe
  6. severe
  7. very severe
59
Q

interpretation: grouping of global deterioration scale scores

A
  • 1-3: pre dementia
  • 4: mild dementia
  • 5: mod dementia
  • 6-7: severe dementia
60
Q

Clinical Dementia Rating (CDR) Scale

A

0: no cog impairment
0. 5: Very mild cog impairment

  1. mild dementia
  2. mod dementia
  3. severe dementia
61
Q

MoCA

A

30 question test. evaluates:

  • orientation
  • short term memory
  • executive function
  • visuospatial ability
  • language abilities
  • animal naming
  • abstraction
  • attention
  • clock drawing
62
Q

Trial Making Tests (part A and B)

A

used to assess:

  • executive function
  • visual search
  • scanning
  • speed of processing
  • mental flexibility
63
Q

relationship between cog function and gait

A
  • higher brain centers involved for planning, execution, balance
  • widespread network to control attention, executive function, visuospatial
  • cerebellum, BG, motor cortex
  • overlapping brain areas to control gait
64
Q

Gait Speed

A
  • Slower in mild and moderate non-AD dementia compared to AD groups and CHI
  • Gait speed predictor of MCI, highly correlated with functional independence and comorbidity
  • sig decrease in MCI compared to CHI
  • sig difference between CHI and CDR levels for UP and FP in dual task
65
Q

Gait Variability

A
  • decreased stride length and greater CoV in AD
  • dual task load sig increased variability in MCI
66
Q

Physical activity and dementia

A
  • exercise provides neuroprotective and neuroplastic effects on brain structures
  • Findings suggest HTN underlying precursor to cog impairment
67
Q

Exercise: how much is enough?

A
  • 150 min/week
  • 5 days/week
  • mod intensity aerobic activity
    OR
  • 60 min/week vigorous
68
Q

Strength Training: recommended dosage

A
  • Moderate-high intensity resistance strengthening 2 days/week for major muscle groups
  • 48-72 hour recovery between sessions
  • 60-80% of 1RM for healthy individuals
  • 40-50% of 1RM for deconditioned or frail individuals
  • 8-12 reps for 2-3 sets
  • 2-3 minute rest period between sets
69
Q

6 domains of balance

A
  • biomechanical constraints
  • stability limits/verticality
  • anticipatory postural adjustments
  • postural responses
  • sensory orientation
  • stability in gait
70
Q

Balance program for cog impairments

A

Balance programs 3 days/week x 3 months involving standing, challenging balance exercises may provide best outcome

71
Q

Cognitive Training programs

A
  1. 6 week cognitive training program (2 sessions/week, 90min each) targeting attention, working memory, planning, verbal fluency, learning, and memory
  2. 10 week computer-based 60 minute cognitive training program, 3 days/week resulted in improved TUG
72
Q

Cognitive Training: VR

A

VR physical and cog training showed greater improvements in gait and cog compared to traditional training

73
Q

Physical Activity Considerations

A
  • physical activity elicits compensatory brain mechanisms that improve cog function
  • 1 year mod aerobic activity improve memory and hippocampal volume in healthy adults
  • combining exercise modalities more effective in enhancing cog health
  • may require higher doses of activity to affect (+) cog function
74
Q

Communitcation w/individuals w/dementia

A
  • Establish eye contact to ensure attention
  • Use short, simple, concrete communication
  • Avoid the use of pronouns (too ambiguous)
  • One topic as a time and repeat/rephrase as necessary
  • Use multisensory input: auditory, visual, tactile
  • Use close-ended questions
  • Use external orientation/memory aids (calendar, signs, etc)
  • Share successful communication techniques with caregivers
  • Reduce background noise
  • Do not stand with glare behind you
  • Always face the patient (avoid standing behind or to the side of pt)
  • If possible, remove mask before speaking
  • Ask questions to confirm patient has understood
  • Avoid interrupting patient
  • Do not take negative comments personally
  • Be patient
75
Q

Working with individuals w/dementia:
Validation Method

A

uses empathy and listening.

acknowledge a person’s thoughts and reality

76
Q

Working with individuals w/dementia:
Focus on Abilities

A

gear interventions and trx toward what the person can still do

77
Q

Working with individuals w/dementia:
exacerbation of neg behaviors can occur when

A
  • new/unfamiliar environment
  • new/unfamiliar caregiver
  • new/unfamiliar routine
  • open environment requiring increased cog processing

special pops (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions