Unit 3| Cognitive impairment and dementia

Question 1

What is the primary focus of this presentation?

Answer 1

The presentation focuses on cognitive impairment and dementia, including normal cognitive aging, mild cognitive impairment (MCI), major neurocognitive disorders, and superaging.

Question 2

What are the main topics covered in this presentation?

Answer 2

The presentation covers normal cognitive aging, mild cognitive impairment, dementia (major neurocognitive disorder), and superaging.

Question 3

What does cognitive aging refer to?

Answer 3

Cognitive aging refers to the changes in cognitive function that occur naturally as people age.

Question 4

How does normal cognitive aging differ from pathological cognitive decline?

Answer 4

Normal cognitive aging does not impair daily living but may involve subtle declines in functional tasks like driving. Pathological cognitive decline includes conditions such as MCI and dementias.

Question 5

What are the two types of intelligence affected by aging?

Answer 5

Crystalized intelligence (overlearned knowledge such as vocabulary and semantic knowledge) remains stable, whereas fluid intelligence (problem-solving, reasoning, attention, memory) declines with age.

Question 6

What is semantic memory?

Answer 6

a type of long-term memory that stores general knowledge about the world, such as facts, concepts, and meanings of words—things you “know” but don’t necessarily remember learning.

Question 7

What are the key changes in processing speed and memory with aging?

Answer 7

Processing speed decreases, affecting information intake and response time. Memory issues arise due to reduced processing speed, selective attention, and strategy use.

Question 8

How does attention change with age?

Answer 8

Aging affects readiness, shifting attention focus, and selective attention during tasks.

Question 9

How do language and visuospatial abilities change with age?

Answer 9

Language fluency and naming ability decline after 70 years. Visuospatial abilities, including recognition and object location, also diminish.

Question 11

What is language fluency?

Answer 11

the ability to speak, understand, read, and write a language easily and smoothly, without much effort or hesitation.

Question 12

What executive functions are affected by aging

Answer 12

Aging impacts concept formation, abstract reasoning, mental flexibility, inhibition, and verbal reasoning.

Question 13

What are the main structural changes in the aging brain?

Answer 13

Gray matter volume declines, particularly in the prefrontal cortex and hippocampus. White matter loss is greater than gray matter loss and affects memory and executive function.

Question 14

What factors influence cognitive aging?

Answer 14

Genetics (60%), medical and psychological conditions, sensory deficits, and environmental factors such as an active lifestyle.

Question 15

What is cognitive reserve?

Answer 15

Cognitive reserve refers to factors that help delay or minimize cognitive decline, including education, social participation, and engaging in complex activities.

Question 16

What activities are associated with better cognitive aging?

Answer 16

Intellectual activities (reading, puzzles), physical activities (dancing, gardening), and social engagement (travel, cultural events, socializing).

Question 17

What is mild cognitive impairment (MCI)?

Answer 17

MCI involves noticeable cognitive decline without significant impact on daily living.

Question 18

How is MCI diagnosed?

Answer 18

MCI diagnosis includes self-reported concerns, impairment in cognitive domains, and preserved independence in daily activities.

Question 19

What are common symptoms of MCI?

Answer 19

Difficulty with complex tasks, mild memory problems, distractibility, and reliance on lists.

Question 20

What are the DSM-V criteria for MCI?

Answer 20

Minor cognitive decline in at least one domain, shown by objective assessment, but not severe enough to interfere with independence.

Question 21

What is dementia?

Answer 21

Dementia is a chronic syndrome marked by cognitive decline that interferes with daily function.

Question 22

What are the impacts of dementia?

Answer 22

Dementia affects memory, executive function, language, and behavior, impacting independence and quality of life.

Question 23

What are the general criteria for dementia syndromes?

Answer 23

A decline in two or more cognitive domains that significantly interfere with daily functioning.

Question 24

What are the main types of dementia?

Answer 24

1. Alzheimer’s Disease (AD): Progressive memory loss, beta-amyloid plaques, and tau tangles.
2. Vascular Dementia (VaD): Caused by strokes or vascular disease.
3. Lewy Body Dementia (LBD): Cognitive fluctuations, hallucinations, and Parkinsonian features.
4. Frontotemporal Dementia (FTD): Affects behavior, social cognition, and language.

Question 25

How common is dementia?

Answer 25

Around 50 million people worldwide suffer from dementia, with approximately 10 million new cases reported each year.

Question 26

What is the most common cause of dementia?

Answer 26

Alzheimer’s disease is the leading cause, accounting for 60-70% of dementia cases.

Question 27

What are some other causes of dementia besides Alzheimer's disease?

Answer 27

Dementia can also result from various diseases and injuries affecting the brain, such as stroke (vascular dementia) and other neurodegenerative conditions.

Question 28

What is a key characteristic of dementia syndromes?

Answer 28

Dementia involves a decline from a previously higher level of cognitive function.

Question 29

How many cognitive domains must be impaired for a dementia diagnosis?

Answer 29

There must be impairment in at least two or more cognitive domains.

Question 30

How do cognitive deficits impact daily life in dementia?

Answer 30

The deficits are severe enough to interfere with normal daily functioning and lead to dependence on instrumental activities of daily living (e.g., managing finances, medication, or household tasks).

Question 31

Can dementia be mistaken for other mental health disorders?

Answer 31

No, the cognitive deficits in dementia are not due to delirium or Axis I disorders such as depression or schizophrenia.

Question 32

What is the primary criterion for diagnosing dementia according to DSM-5?

Answer 32

There must be a significant cognitive decline from a previous level of performance in at least one or more cognitive domains.

Question 33

What cognitive domains are assessed in dementia diagnosis?

Answer 33

The domains include complex attention, executive ability, learning and memory, language, visual constructional-perceptual ability, and social cognition.

Question 34

How is cognitive decline identified?

Answer 34

Cognitive decline is determined through: a) Self-report, reports from a knowledgeable informant, or clinical observation. b) Objective assessment, showing performance below the 2.5th percentile or < -2 standard deviations.

Question 35

How do cognitive deficits affect daily life?

Answer 35

The deficits are severe enough to interfere with independence, requiring assistance with instrumental activities of daily living (e.g., managing finances, medications, or household tasks).

Question 36

What are the main categories of dementia classification?

Answer 36

Dementia is classified into cortical, subcortical, and mixed types.

Question 37

What are the key features of cortical dementias?

Answer 37

Cortical dementias primarily affect higher cognitive functions, including: - Learning and episodic memory - Severe language deficits - Visuospatial skills (e.g., navigation and orientation) - Executive function

Question 38

How do subcortical dementias differ from cortical dementias?

Answer 38

Subcortical dementias mainly affect motor and cognitive processing speed, with features such as: - Motor dysfunction - Slowness of thought - Prominent deficits in executive function and attention - Visuoperceptual and constructional difficulties (e.g., apraxia) - Mild to moderate impairment in memory and language --> Vascular dementia

Question 39

What are examples of mixed dementias?

Answer 39

Mixed dementias include: 1. Lewy Body Disease (combining features of both cortical and subcortical dementia) 2. Frontotemporal Dementia (affecting behavior, personality, and language)