Geriatric Psychiatry

Question 1

What is Old-Age Psychiatry? A sub-specialty of psychiatry focusing on the assessment and treatment of mental illness in older adults

Answer 1

typically aged 65 and over.

Question 2

Name three key mental health conditions prevalent in older adults. Dementia

Answer 2

depression

Question 3

Which condition often presents with low mood

Answer 3

somatic symptoms

Question 4

How does depression in older adults differ from younger adults? More likely to present with somatic complaints

Answer 4

psychomotor changes

Question 5

What screening tool is validated for depression in older adults? Geriatric Depression Scale (GDS).

Question 6

What are the three subtypes of delirium? Hyperactive

Answer 6

hypoactive

Question 7

What is the most common cause of delirium in older adults? Infection

Answer 7

particularly urinary tract infections and pneumonia.

Question 8

What is the first-line management for delirium? Identify and treat the underlying cause; ensure supportive care and orienting measures.

Question 9

What are the four main types of dementia? Alzheimer’s disease

Answer 9

vascular dementia

Question 10

What is the most common type of dementia in the UK? Alzheimer’s disease.

Question 11

What is the first-line investigation for cognitive impairment in older adults? Cognitive screening using tools like MMSE

Answer 11

ACE-III

Question 12

What are common causes of psychosis in older adults? Late-onset schizophrenia

Answer 12

dementia with Lewy bodies

Question 13

What are the general principles of managing mental health conditions in older adults? Use the least restrictive interventions

Answer 13

account for physical comorbidities

Question 14

What UK legal frameworks are relevant in old-age psychiatry? Mental Capacity Act 2005 and the Mental Health Act 1983 (as amended in 2007).

Question 15

Name two safeguarding issues more prevalent in older adults. Elder abuse and self-neglect.

Question 16

What is an important social intervention in dementia care under UK guidelines? Cognitive stimulation therapy (CST).

Question 17

What is dementia? A chronic

Answer 17

progressive syndrome due to brain disease

Question 18

What is delirium? An acute

Answer 18

transient disturbance in attention and cognition

Question 19

Name the four main types of dementia. Alzheimer’s disease

Answer 19

vascular dementia

Question 20

List three common causes of delirium. Infection (e.g. UTI

Answer 20

pneumonia)

Question 21

What pathological changes are seen in Alzheimer’s disease? Amyloid-beta plaques and neurofibrillary tangles of hyperphosphorylated tau.

Question 22

What causes the fluctuating cognition in delirium? Acute neurotransmitter imbalance (especially acetylcholine and dopamine)

Answer 22

often due to systemic stressors.

Question 23

What are hallmark features of delirium? Sudden onset

Answer 23

fluctuating consciousness

Question 24

What is typically the first symptom in Alzheimer’s dementia? Short-term (episodic) memory loss.

Question 25

What bedside tests are used to assess cognition in dementia and delirium? AMTS

Answer 25

4AT (for delirium)

Question 26

What investigations are recommended in suspected delirium? FBC

Answer 26

U&E

Question 27

What is first-line management for delirium? Identify and treat underlying cause

Answer 27

provide supportive care

Question 28

Name a non-pharmacological intervention recommended for mild-to-moderate dementia. Cognitive Stimulation Therapy (CST).

Question 29

What are long-term complications of dementia? Loss of independence

Answer 29

behavioural and psychological symptoms (BPSD)

Question 30

Why is delirium considered a medical emergency in older adults? It is associated with increased mortality

Answer 30

prolonged hospital stay