Ch 14 Psych 14
Pseudo-dementia
- "fake" dementia - development of dementia-like symptoms - apathy, psychomotor retardation, impaired concentration, delusions, and confusion - can be accompanied by memory loss, and these individuals complain of memory loss more that those with true dementia.
Vascular Neurocognitive Disorder
A form of major or mild neurocognitive disorder resulting from cerebrovascular events (strokes) affecting the brain.
Agnosia
A disturbance of sensory perception, usually affecting visual perception
Korsakoff's syndrome
A syndrome associated with chronic alcoholism that is characterized by irreversible memory loss due to brain damage, resulting from deficiency of vitamin B1 (thiamine). • Often follows acute attack of Wernicke's disease
Neurocognitive disorder due to Lewy body dementia
Abnormal protein deposits that form within the nucleus of cells in parts of the brain. • About 10% of dementias in older adults • Profound cognitive decline • Fluctuating alertness and attention • Frequent periods of drowsiness and staring into space• Recurrent visual hallucinations • Rigid body movements, stiff muscles
infarction
Blockage of the blood vessels supplying the brain.
Alzheimer's: Diagnosis and Symptom
Brain-scanning technology allows doctors to diagnose AD based on brain scans showing plaques associated with the disease together with clinical evidence of memory loss. • Early stages of the disease are marked by limited memory problems and subtle personality changes. • In moderately severe AD, people require assistance in managing everyday tasks. • The advanced stage may included talking to self, visual hallucinations, and paranoid delusions.
Alzheimer's: Causal Factors
Cause of AD unknown • Possible contributing factors: • Formation of plaques and tangled nerve fibers in the brain • Genetic variant called the ApoE4 gene • Environmental factors
Elizabeth Kubler-Ross's Stage Theory of Dying: DABDA
D enial Anger Bargaining D epression A cceptance Criticized for not being scientifically validated and not reflecting individual differences
Hypoxia
Decreased supply of oxygen to the brain or other organs.
Anterograde Amnesia Patient H.M
H.M. A patient with anterograde amnesia identified as H.M. in the neurology annals was among the most studied cases in medical history. The patient, Henry Molaison, pictured here outside his home in the 1970s, died in 2008. Had you met Henry and then walked away for a few minutes, he would later greet you as though he were meeting you for the first time.
Aphasia
Impaired ability to understand or express speech.
Retrograde amnesia
Loss of memory of past events and personal information.
Ataxia
Loss of muscle coordination.
What is Dementia?
a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning • Memory Deficits, PLUS: Agnosia, Aphasia, Apraxia, Ataxia
Wernicke's disease
brain disorder caused by thiamine deficiency that occurs most often among people with alcoholism • Major gaps in memory of past experiences and significant difficulty learning new information • Can become grossly disoriented and confused, and require custodial care
Erik Erickson's Stage 8 of Psychosocial Development
ego integrity and despair
Prevalence of delirium
estimated at about 1% to 2% in the general community, but rises to 14% among people over the age of 85 • Delirium tremors from chronic alcoholism
Apraxia
inability to execute learned purposeful movements
Neurocognitive Disorder Due to Prion Disease
occurs when clusters of abnormal prion molecules spread within the brain. • Best known example of prion disease is Creutzfeldt-Jakob disease • A rare but fatal brain disease characterized by the formation of small cavities in the brain that resemble the holes in a sponge • The disease causes brain damage, which commonly results in dementia (major neurocognitive disorder) • Symptoms usually begin in late 50s • No treatment -death results within months of symptoms
Alzheimers disease (AD)
A degenerative brain disease that leads to progressive and irreversible dementia, characterized by memory loss and deterioration of other cognitive functions, including judgment and ability to reason. • Risk increases dramatically with advancing age • Expected to affect approximately 16 million people by the year 2050
Frontotemporal Neurocognitive Disorder
A disorder characterized by the deterioration of brain tissue in the frontal and temporal lobes of the cerebral cortex. • Symptoms include memory loss and socially inappropriate behavior, such as loss of modesty or the display of flagrant sexual behavior • Originally known as Pick's disease • Usually begins in middle age • Genetic component
Major neurocognitive disorder (dementia)
A profound decline or deterioration in mental functioning characterized by significant impairment of memory, thinking processes, attention, judgment, and by specific cognitive deficits. • Most frequent cause is Alzheimer's disease (AD) • Usually follows a progressive and irreversible course • Typically occurs in people over the age of 80 • Late-onset dementia -after age 65 • Early-onset dementia (Presenile dementias) -65 or earlier
Neurocognitive Disorder Due to Parkinson's Disease
A progressive disease characterized by uncontrollable shaking or tremors, rigidity, disturbances in posture, and lack of control over body movements and destruction or impairment of dopamine producing nerve cells in the substantia nigra ("black substance"), an area of the brain that helps regulate body movement • Affects between half a million and one million people in the United States • Most often strikes between the ages of 50 and 69 • Dementia occurs in about 80% . • The drug L-dopa, which increases dopamine levels, brought hope to Parkinson's patients when it was introduced in the 1970s. L-dopa is converted in the brain into dopamine
Delirium
A state of extreme mental confusion in which people have difficulty focusing their attention, speaking clearly and coherently, and orienting themselves to the environment. • Disturbances in perception • Dramatic slowing of movement • Fluctuations between restlessness and stupor
Cerebrovascular accident (CVA)
A stroke or brain damage resulting in a disruption in its blood supply, usually as a result of a blood clot that becomes lodged in an artery that services the brain and obstructs circulation. • Symptoms include impaired memory and language ability, agitation, emotional instability, unable to attend to basic needs.
Headed Toward Dementia?
A study by the National Football League (NFL) in 2009 showed reports of dementia and significant memory problems among retired football players to be much higher than the rate found in the general population. • CTE -Chronic Traumatic Encephalopathy. More recently, preliminary results of a small study done by UCLA researchers of brain images of five retired NFL players showed evidence of abnormal brain proteins associated with AD.
WHAT CHANGES TAKE PLACE AS WE AGE, AND HOW DO THEY AFFECT OUR MOODS?
Although some declines in cognitive and physical functioning are connected with aging, older adults who remain active and engage in rewarding activities can be highly satisfied with their lives.
Neurocognitive Disorder Due to Huntington's Disease
An inherited degenerative disease from the progressive deterioration of the basal ganglia that is characterized by jerking and twisting movements, mental deterioration, and unstable moods • Most prominent physical symptoms of the disease are involuntary, jerky movements of the face (grimaces), neck, limbs, and trunk • Affect about 30,000 people in the United States • Typically begins between ages of 30 and 45 • Caused by a genetic defect on a single gene
Anxiety and Aging
Anxiety disorders are the most commonly occurring psychological disorder among older adults, even more common than depression. • Approximately 1 in 10 adults over the age of 55 suffers from a diagnosable anxiety disorder • Most common -generalized anxiety disorder and phobic disorders • Antianxiety drugs often used
Mild neurocognitive disorder
Applies to people who suffer a mild or modest decline in cognitive functioning from their prior level. Able to function independently and complete everyday tasks at home and on the job The inclusion of a new diagnosis of mild neurocognitive disorder in DSM-5 highlights the need to identify cases that can be targeted for early intervention
Psychological Disorders Related To Aging
Dementia, or senility, is not the result of normal aging. It is a sign of degenerative brain disease. Screening (MRIs) and testing on neurological and neuropsychological tests can help distinguish dementias from normal aging processes. Generally speaking, the decline in intellectual functioning in dementia is more rapid and severe.
Neurocognitive disorders
Disorders diagnosed on the basis of deficits in cognitive functioning that represent a marked change from the individual's prior level of functioning. are not psychologically based; they are caused by physical or medical diseases, or drug use/withdrawal that affect the functioning of the brain. •In some cases the specific cause of the disorder can be pinpointed; in others, it cannot.
Alzheimer's: Treatment & Prevention
Drug treatment provides modest benefits in slowing cognitive decline and boosting cognitive functioning -donepezil/Aricept increases levels of neurotransmitter acetylcholine (ACH)-Memantine (Namenda XR) is used to treat moderate to severe confusion (dementia ) related to Alzheimer's disease . • Engaging in stimulating cognitive activities can help boost cognitive performance in people with mild to moderate AD. • Lifestyle factors such as maintaining a regular exercise program and following a healthy diet may reduce the risk of AD.
Neurocognitive Disorder Due to Traumatic Brain Injury
Head trauma results from jarring, banging, or cutting brain tissue from injury or assault • More likely to result from multiple head traumas than from a single blow • Can cause progressive dementia Amnesia Memory loss that frequently follows a traumatic event
Grief and Death Review
Match the following statements with Elisabeth KüblerRoss's supposed five-stage theory of death and dying: ___a. "I understand that I'm dying, but if I could just have a little more time . . ." ___b. "I refuse to believe the doctors. I want a fourth opinion." ___c. "I know my time is near. I'd better make plans for my spouse and children." ___d. "Why me? I've been a good person. I don't deserve this." ___e. "I'm losing everything. I'll never see my children again. Life is so hard."
Amnesia
Memory loss that frequently follows a traumatic event, such as a blow to the head, an electric shock, or a major surgical operation.
Sleep Problems and Aging
Sleep problems, especially insomnia, are common among older people. • Upward of 50% of older adults report sleep problems • Often linked to other psychological disorders, such as depression, dementia, and anxiety disorders, as well as medical illness • Psychosocial factors, such as loneliness and the related difficulty of sleeping alone after the loss of a spouse, also implicated in many cases • Sleep medications used, but can cause side effects and lead to dependence
Neurocognitive Disorder Due to HIV Infection
The human immunodeficiency virus (HIV), which causes AIDS, can invade the central nervous system and cause a minor or major neurocognitive disorder. • The major cognitive effects include forgetfulness, impaired concentration, and problem-solving ability • Dementia is rare in persons who have not yet developed full-blown AIDS • Common behavioral features are apathy and social withdrawal • As AIDS progresses, dementia grows more severe
Anterograde amnesia
an inability to form new memories
Depression and Aging
is a common problem affecting many older adults, especially those with a prior history of depression Pseudo-dementia? • For many, depression often involves a continuation of a lifelong pattern • Approximately 1% and 5% of older adults are currently suffering from a diagnosable major depressive episode • Effective treatments include antidepressant medication, cognitivebehavioral therapy and interpersonal therapy