chapter 15
_____ of elderly persons take antidepressant medications.
14%
The percentage of the elderly population living in nursing homes at any given time is about:
4 percent.
In most cases, this neurocognitive disorder can be diagnosed with certainty only after death.
Alzheimer's disease
To control occasional pain and inflammation, a person uses an over-the-counter drug containing ibuprofen. Interestingly, recent research shows that the person also may be reducing the risk of contracting which disease?
Alzheimer's disease
This neurocognitive disorder includes symptoms of body spasms.
Creutzfeldt-Jakob disease
Which statement is accurate regarding Alzheimer's disease?
It is sporadic and most often starts after age 65.
This neurocognitive disorder is rare and affects the frontal and temporal lobes.
Pick's disease
The percentage of the U.S. population today aged 65 and older is:
about 13 percent.
Depletion of the neurotransmitter acetylcholine has been implicated as a:
critical factor in Alzheimer's disease.
Which of the following anxiety disorders is most common among the elderly?
generalized anxiety disorder
An elderly individual has just been diagnosed with an anxiety disorder. MOST likely, the diagnosis is:
generalized anxiety disorder.
A particular problem found MORE often in the elderly that is related to substance abuse is:
misuse of prescription drugs.
Lisa Mosconi and her associates administered PET scans to research participants to measure activity in the hippocampus. They found that participants with low hippocampus activity were more likely to develop neurocognitive disorders later in life. How accurate were their predictions?
more than 70 percent accurate for mild neurocognitive impairment and more than 80 percent accurate for major neurocognitive impairment
Those who begin unhealthy drinking patterns later in life typically begin as a response to:
negative events and pressures of growing older.
Alzheimer's disease is conclusively diagnosed on the basis of:
neurofibrillary tangles and senile plaques evident at autopsy.
If you had a PET scan at a relatively young age to predict your likelihood of developing Alzheimer's, you would be most disturbed if you had:
reduced hippocampus activity.
Timothy is in his 60s. He has suffered from a psychotic disorder his entire life but the symptoms of the disorder have lessened as he has gotten older. Which disorder did he likely have?
schizophrenia
This neurocognitive disorder follows a stroke.
vascular neurocognitive disorder
"I'm no fool, no sirree! I'm gonna live to be 103. . . ." sang the Disney character Jiminy Cricket decades ago. If Jiminy Cricket had been a human (most crickets live only a few weeks), what's the BEST advice you could have given him to live a very long life?
"Accept life's challenges with optimism, have good health habits, and inherit 'longevity' genes."
"Grandma is 65 years old, and there's no sign of neurocognitive disorder," says a friend of yours. Your MOST accurate reply is:
"That's fairly typical—about 1 to 2 percent of people that age do have signs of neurocognitive disorder."
"Grandpa is 88 years old, and there's no sign of neurocognitive disorder," says a friend of yours. Your MOST accurate reply is:
"That's wonderful—about half of people that age do have signs of neurocognitive disorder."
A friend says, "My 70-year-old grandmother is in good physical health but has been diagnosed with depression. Should she even bother getting therapy? She is pretty old, after all." Your BEST research-based answer is:
"Yes, more than half of elderly patients show improvement with treatment."
"In dealing with Alzheimer's disease, exercise is the key," says a friend of yours. Which statement would be your BEST reply?
"You're right—exercise may reduce the chances of developing Alzheimer's, and it may help treatment if the disease does develop."
Of 100 typical elderly patients entering a hospital for a general medical condition, about how many would initially be diagnosed with delirium, and about how many more would develop delirium while in the hospital (in that order)?
10 percent, 10 percent
The elderly currently make up about _____ of the total population in the United States.
14%
Around _____ of the elderly have four or more chronic conditions.
15%
The elderly are expected to make up more than _____ of the United States population by 2030.
20%
_____ of elderly persons take cholesterol-lowering medications.
47%
About how many new cases of neurocognitive disorders occur each year?
5 million
Survey research shows that alcohol-related disorders affect about:
5 percent of the elderly, more often men.
Robert is a white American man. How long can he expect to live?
76
If an elderly person lives to the age of 80, he or she can expect to live an additional _____.
8 years
Margaret is a white American woman. How long can she expect to live?
81
The average life expectancy for Hispanic American women is about _____ years of age.
84
About what percentage of those with Alzheimer's disease are cared for by their relatives?
90 percent
With this neurocognitive disorder, the time between onset and death is between 8 and 10 years.
Alzheimer's disease
_____ accounts for almost two-thirds of all neurocognitive disorders
Alzheimer's disease
The MOST feared psychological problem among the elderly is:
Alzheimer's disease.
The MOST frequent cause of neurocognitive disorder in the elderly is:
Alzheimer's disease.
Your elderly grandfather is deteriorating. At first he seemed only mildly forgetful, but lately he has had trouble recalling the names of close relatives and cannot remember where he is. He used to be very loving and patient, but now he is very unpleasant and his condition is worsening. He is MOST likely experiencing:
Alzheimer's disease.
What is the relationship between age and anxiety in the elderly?
As age increases, the rate of anxiety disorders increases.
Which is the correct ordering of ethnic groups in the United States in terms of the percentage of the elderly living with their children (from highest percentage to lowest percentage)?
Asian American, African American, Hispanic American, white American
_____ is a rapidly developing, acute disturbance in attention and orientation that makes it very difficult to concentrate and think in a clear and organized manner.
Delirium
Which statement regarding the use of drug therapy to slow down the progression of Alzheimer's disease is accurate?
Drug therapy slows down the disease in patients treated early in the course of a milder form of the disease
This psychomotor test is used to help screen for neurocognitive disorders.
Gesture imitation test
Neurocognitive disorders are also associated with:
HIV
Lucille experiences severe mood, personality, and movement changes. Her condition is progressive and inherited. She MOST likely has:
Huntington's disease.
What does the research show that nursing homes should do to meet the emotional needs of their patients?
Let patients do what they want to do, so long as it's not harmful or disruptive.
Which disease involves degeneration of the frontal and temporal lobes?
Pick's disease
What generally happens in the thalamus and the hypothalamus of an individual with Alzheimer's disease?
Selected neurons die.
Among the "oldest old," those who are older than 95 years old, the MOST common concern is:
a fear of losing mental abilities.
Which cognitive functioning does NOT experience a significant decline when a person has a neurocognitive disorder?
auditory perception
"Triple jeopardy," as an issue affecting the mental health of the elderly, refers to:
being old, a minority member, and a woman.
The molecules that are found in sphere-shaped deposits in spaces between neurons in the hippocampus in individuals with Alzheimer's disease are called:
beta-amyloid protein.
A person who has an excess of plaques due to Alzheimer's would be likely to have:
cell breakdown and neuron death.
An elderly person has been diagnosed with a neurocognitive disorder, but the disorder is not Alzheimer's disease. Among the elderly, such a diagnosis is:
common—about a third of neurocognitive disorders are not Alzheimer's disease.
With Alzheimer's disease, physical health usually:
declines less rapidly than mental health
Those suffering from this may believe that it is morning in the middle of the night or that they are home when actually they are in a hospital room.
delirium
With _____, a person's focus suddenly becomes less clear, he or she has great difficulty concentrating and thinking in an organized way, leading to misinterpretations, illusions, and, on occasion, hallucinations.
delirium
A clouding of consciousness that develops over a short period of time and can often be reversed if its underlying cause can be found is called:
delirium.
An 80-year-old hospitalized individual is recovering from surgery but now has gotten an infection. Over the course of a few days, the person shows increasing confusion and consistently misinterprets what others are trying to communicate. The MOST probable diagnosis for this condition would be:
delirium.
An elderly person who develops false beliefs that are not bizarre is MOST likely suffering from:
delusional disorder.
The first reaction to early symptoms of Alzheimer's disease typically is:
denial of symptoms.
The typical pattern of Alzheimer's for the patient is:
denial, anxiety, withdrawal, dependency.
Senile plaques and neurofibrillary tangles:
differ in location; senile plaques are found between neurons in the brain, while neurofibrillary tangles are found within neurons in the brain.
Alzheimer's is a brain _____ while stroke is a brain _____.
disease; injury
If a young person is taking a health-maintenance approach to aging, the person would be:
doing things that promote physical and mental health.
Regarding treatment of depression in the elderly, studies show that:
drug treatments may need to be altered because drugs are broken down differently in the older body.
Beatitudes, a facility that offers long-term inpatient care for individuals with Alzheimer's disease, provides controls for patients by:
focusing on individualized care, such as allowing access to alcohol or chocolate.
If you do things during your life that promote physical and psychological well-being, you are engaging in a _____ approach to aging.
health-maintenance
An elderly (older than 65) member of your community has just started using the Internet to keep up with friends and family. This community member is:
increasingly common: the number of elderly individuals using the Internet has doubled, then redoubled, in recent years.
A 65-year-old in otherwise very good health typically will experience occasional:
memory difficulties.
In people with Alzheimer's disease, memory problems appear to be caused by disruption of the production of:
memory-linked proteins.
Some worry that many elderly who display normal forgetfulness and other common features of growing older will incorrectly receive this diagnosis.
mild neurocognitive disorder
The DSM-5 added this category in order to help clinicians detect individuals in the early stages of Alzheimer's disease.
mild neurocognitive disorder
An individual with Alzheimer's disease is able to function independently. The MOST appropriate label for this person's condition is:
mild neurocognitive disorder.
A person who abuses alcohol often drinks alone, blacks out occasionally, and falls a lot. These characteristics are:
more than twice as common in young alcohol abusers as they are in elderly alcohol abusers.
Approximately what proportion of nursing home residents is receiving antipsychotic drugs?
one-third
The part of the brain MOST important for short-term (working) memory is (are) the:
prefrontal cortex
You would suspect a problem in the _____ for someone experiencing difficulty with short-term memory.
prefrontal cortex
An elderly individual has just been diagnosed with depression. In the future, that individual would be expected to:
recover more slowly than average for both injuries and illnesses.
Sphere-shaped deposits of a small molecule in spaces between neurons in the hippocampus in individuals with Alzheimer's disease are called:
senile plaques.
The brain changes that those with Alzheimer's disease experience are:
similar to those of most elderly people, but they happen to an excessive degree.
Women who want to reduce their risk of developing Alzheimer's should:
take estrogen for years after menopause.
Given the role of the hippocampus in long-term memory formation, you would suspect a problem in the _____ for someone experiencing difficulty with long-term memory.
temporal lobes
Which situation is MOST likely to lead to hospitalization for an Alzheimer's patient?
the home caretaker being overwhelmed
Studies have shown that misuse of medications in U.S. nursing homes occurs MOST often when staff members:
use antipsychotic drugs to control the behaviors of those who don't show psychotic symptoms.
With this neurocognitive disorder, the person's cognitive functioning may continue to be normal in areas of the brain that were not affected by a stroke or other cerebrovascular accident.
vascular neurocognitive disorder
A person quite suddenly begins to show specific cognitive impairment and difficulty in speaking, yet other cognitive functions appear normal. MOST likely, that person is experiencing:
vascular neurocognitive disorder.
Other than an autopsy after death, the BEST way to diagnose the presence of Alzheimer's disease is:
with a brain scan of hippocampal function.
Which is MOST likely to be said by an elderly person regarding long-term care?
"I'm worried about how my life will change."
The maximum attainable age by humans is thought to be _____ years.
122
_____ of elderly persons take diabetes medications.
18%
More than _____ of the elderly meet the criteria for a mental disorder.
20%
What percentage of the elderly now use Facebook?
45%
_____ of elderly persons take cardiovascular medications.
70%
African American men can expect to live about _____ years of age?
71
The fact that Alzheimer's disease resembles Creutzfeldt-Jakob disease suggests that Alzheimer's may be caused by:
a virus.
An individual is extremely sad, can't sleep well, and experiences very low, and decreasing, self- esteem. These are features of depression among:
both the elderly and the young.
Abnormal activity involving which element appears to contribute to the symptoms of Alzheimer's disease?
calcium
An individual has just been diagnosed with mild neurocognitive disorder. We know for sure that the person:
can still function independently.
A person has normal acetylcholine and glutamate activity. If that person is suspected of having Alzheimer's disease, one might look next for:
an imbalance in the breakdown of calcium in the brain.
One of the MOST frequent reasons for the institutionalization of Alzheimer's patients is:
because home caregivers are overwhelmed.
Compared to individuals who are older than 75 and living at home with assistance, similar individuals living in nursing homes are almost twice as likely to experience delirium, providing evidence that:
experiencing delirium is positively correlated with living in a nursing home.
Older individuals with Alzheimer's disease differ from older individuals without Alzheimer's disease in that they:
have an extraordinary number of neurofibrillary tangles.
To date, research shows that anxiety among the elderly is MOST related to:
health.
Sources of discrimination in the mental health care of the elderly include:
language barriers that interfere with medical and mental health care.
Among the elderly, schizophrenia is:
less common than among younger individuals, and there are fewer new cases per year.
Compared to younger people, those older than 65 are:
less likely to experience depression if not living in a nursing home and more likely to experience depression if living in a nursing home.
A partially supervised apartment, a senior housing complex for mildly impaired elderly people, and a nursing home with round-the-clock care are all examples of:
long-term care.
Recent research shows that a person developing Alzheimer's disease is related to:
lower hippocampus activity earlier in life.
About 17 percent of individuals with Alzheimer's disease also experience:
major depressive disorder.
An individual with Alzheimer's disease is no longer able to function independently. The MOST appropriate diagnosis for this person's condition is:
major neurocognitive disorder.
This form of therapy is particularly useful in treating anxiety disorders among the elderly.
cognitive-behavioral therapy
Which is an example of a sociocultural approach to treating Alzheimer's?
day-care facilities
As people age, the incidence of alcohol abuse and other forms of substance abuse:
decreases.
The term "double jeopardy" describes people who may develop psychological problems because of being:
old and members of an ethnic minority.
Which is NOT a proposed cause of Alzheimer's?
concussion or other brain injury
_____ typically develops over a short period of time, usually hours or days.
Delirium
An individual seeking help from a geropsychologist is MOST likely: elderly.
elderly.
Research evaluating sociocultural approaches to dealing with Alzheimer's disease, for example, assisted-living facilities and day-care facilities, shows that, in general, patients receiving these forms of care:
enjoy life more and don't continue to decline as quickly.
This anxiety disorder affects up to 7% of the elderly.
generalized anxiety disorder
Studies of the "oldest old" show that compared to people in their 80s and early 90s, the oldest old are usually:
more agile, healthier, and clearheaded.
People older than 85 are about how many times as likely to experience delirium, compared to those closer to age 55?
more than ten times as likely
This neurocognitive disorder is an inherited progressive disease in which memory problems along with personality changes and mood difficulties worsen over time.
neurocognitive disorder due to Huntington's disease
Someone who has AIDS is also at risk for developing:
neurocognitive disorder.
Among the elderly, psychotic cognitive symptoms are usually due to:
neurocognitive disorders.
Which of the following is NOT a common trigger for depression in old age?
stability of residence or environment
Brenda is a Hispanic American woman. How long can she expect to live?
84
What would be the BEST advice to give someone who wants to retain good cognitive functioning as long as possible in old age?
"Exercise your body and your mind—use it or lose it."
If this neurocognitive disorder occurs before the age of 65 it is thought to have a stronger genetic component.
Alzheimer's disease
This is the most common type of neurocognitive disorder.
Alzheimer's disease
Who would be expected to live the longest?
Maria, a Hispanic American woman
An individual suffering from a neurological disorder shows no evidence of infection or poisoning but experiences tremors, rigidity, and unsteadiness. The MOST probable diagnosis is:
Parkinson's disease.
An elderly person who believes falsely that others are conspiring against her, cheating her, or spying on her and who behaves in angry, irritable, and depressed ways is exhibiting:
a delusional disorder.
Which of the following is the leading cause of death among the elderly?
heart disease
Which of the following chronic conditions is the MOST prevalent among the elderly?
high blood pressure
Alzheimer's is named for the first person to _____ the disease.
identify
A person with Alzheimer's disease is taking a drug designed to affect acetylcholine and glutamate and may experience modest:
improvement both in short-term memory and in ability to cope under pressure.
Which is NOT listed in text as associated with depression in the elderly?
increased financial problems
Which has NOT been used as a cognitive treatment for Alzheimer's disease?
increasing the capacity of short-term memory by memorizing strings of random numbers
Samuel, who is older than 65, reports taking six prescription drugs, in addition to regularly taking two over-the-counter drugs. Among the elderly, Samuel is:
normal; the average elderly individual takes about this amount of drugs.
Mary is now a 70-year-old woman who suffered from a psychotic disorder when she was younger. As she has gotten older the symptoms of this disorder have declined. Which psychotic disorder did she likely have?
schizophrenia
Symptomology of this psychotic disorder tends to decline in later life.
schizophrenia
Research on the cause of Alzheimer's disease has led to the conclusion that:
there appears to be a significant hereditary component, but this does not fully explain its onset.
The best evidence we have to date suggests that early-onset Alzheimer's is transmitted genetically in families that:
transmit mutations of certain protein-producing genes.
People over _____ are the fastest growing segment of the population in the United States and around the world.
85
Which would be at greatest risk for depression?
an older woman in a nursing home
