Cognition, Attention, Memory

Front 1

What is normal with language and healthy aging?

Back 1

1. Anomia increases
2. Vocab stable/increases
3. Sentence structure becomes simpler
4. Deficits in working memory & comprehension d/t prebycusis
5. Reading/writing, motoric & visual perceptual impact
6. Pragmatics (off-topic verbosity)

Front 2

Cognitive slowing

Back 2

1. slow processing speed & less accurate on sensory, motor tasks, perceptual & cognitive tasks

2. decreased inhibition- tend to have "cluttered" working memory which leads to poor performance

3. Attention- sustained & divided decreases over time (immediate-little to no difference)

Front 3

Age-associated memory impairments

Back 3

- 50 + y/o
- Gradual onset w/out sudden worsening in recent months
- Memory test performance is at least 1 SD below mean

- ~84% of older population does NOT experience measurable decrease in memory function

Front 4

What NOT impaired in memory with normal aging?

Back 4

Less impairment in:
- Semantic
- Procedure
- Immediate
- Remote
- Recognition

Front 5

What type of memory is typically impaired in with normal aging?

Back 5

- Episodic memory!!
- Recall

Difficulty retrieving recent learned info in a recall format

Front 6

Which age population uses bottom-up vs. top-down processing?

Back 6

Bottom up- younger adults

Top down- older adults

Front 7

What is PRESBYOPIA?

CATARACT?

GLAUCOMA?

MACULAR DEGENERATION?

Back 7

PRESBYOPIA: Reduced ability of older eye to accommodate or adjust focus to see objects clearly at any distance

CATARACT: decrease in len's transparency

GLAUCOMA: build up of pressure w/in eye

MACULAR DEGENERATION: impaired central vision (aka blind)

Front 8

What is Post Traumatic Amnesia?

Back 8

PTA= Length of time post onset where NO new learning occurs

It includes the period of coma & extends until the pt's attention & memory for ongoing events becomes reliable, consistent & accurate

Front 9

Galveston Orientation and Amnesia is a common scale to evaluate?

Back 9

PTA (post traumatic amnesia)

Front 10

Glascow Coma Scale assesses?

Back 10

Assessment of Orientation, Awareness & Responsiveness

Scores range fom 3-15

Front 11

What does ATTENTION involve?

Back 11

Capacity (attend to info) & Control (focus on info)

Front 12

What is focused attention?

Back 12

Ability to respond directly to an auditory, visual or tactile stimulus

Front 13

What is sustained attention?

How can you evaluate it?

Back 13

Ability to maintain a consistent level of response performance over time on a continuous/repetitive activity

Consists of:
1. Vigilance
2. Mental control or Working Memory

Evaluated by:
- Digit span backwards
- Letter cancellation tasks (normal if 4+ recalled)

Front 14

What is a formal tx method for sustained attention?

Back 14

Attention Process Training Program (APT)

- Repetitive stimuli of targeted type of attention thru use of progressively more difficult tasks will lead to improved attention

Front 15

What is selective attention?

How can you evaluate it?

Back 15

Ability to maintain a given level of responding in the presence of distracting competing stimuli

Stroop Test- word "red" may be printed in green ink & pt must respond with "green"

Front 16

What is alternating attention?

Back 16

Ability to shift the focus of attention back and forth between two or more tasks while maintaining a given level of response

Front 17

What is a formal assessment for alternating attention?

Back 17

Symbol-Digit Modalities Test:
pt writes numbers that correspond to various geometric symbols using a reference table (cancellation tasks)

Front 18

What is divided attention?

Back 18

The capacity to attend to and respond to two or more tasks/items simultaneously

ex. driving a car, cooking

Front 19

What formal assessment can we use to test divided attention?

Back 19

(PASAT) Paced Auditory Serial Addition Test:
pt listens to a series of numbers. They add the first two numbers they hear and tell you sum as other numbers continue to be presented at specific rate...

Front 20

What is Attention Process Training (APT)?

Back 20

Theoretically based tx for the 5 levels of attention processing (sustained, selective, alternating, divided)

Designed for pts w/ TBI (mild-severe)

Front 21

Rancho Scale I

Back 21

True coma;

No response to external stimuli

Front 22

Rancho Scale II

Back 22

Semi-coma;

Generalized response (gives same behavior response for any time or stimuli)

Front 23

Rancho Scale III

Back 23

Localized but purposeful response;

Some differential responding to stimuli, OCCASIONALLY follows a command

Front 24

Rancho Scale IV

Back 24

Confused and agitated;

Disoriented to time, place, & circumstance of hospitalization;

May become agitated/aggressive from overstimulation

Pt has severe memory, attentional, and reasoning/problem solving deficits

Front 25

Rancho Scale V

Back 25

Confused but NOT agitated;

Remain disoriented to time and sometimes place/circumstance;

Able to respond to simple commands and can do most routine/simple ADLs WITH supervision;

Memory and new learning is SEVERELY impaired

Front 26

Rancho Scale VI

Back 26

Confused but APPROPRIATE;

Most problems result from impaired recent memory (new learning);

Impaired attention skills, poor safety judgement, and poor executive functioning

Can complete ADLS with LESS supervision however pt con't to need 24 supervision d/t poor judgement & occasional confusion

Front 27

Rancho Scale VII

Back 27

Automatic appropriate responses

Pt is oriented to time/place consitently

Can complete ADLs WITHOUT supervision

BUT they may continue to have some difficulty w/ new learning, problem solving, and judgement which can make going-back-to-work difficult and being independent

Front 28

Rancho Scale VIII

Back 28

Purposeful appropriate responding, characterized by some significant improvement in new learning, reasoning skills, safety judgement, and independence.

Although pt usually don’t need supervision they may cont to have focal memory problems, poor stress tolerance, and difficulty with higher level problem solving

Front 29

What is working memory?

Back 29

Working memory= sensory reception to short term

Ability to store and manipulate info for the first 0-30 secs after registration

Mechanism for short-term holding and computational processes

Includes both immediate aspects of simple attention and more complex manipulation that is needed to hold and process info simultaneously

Front 30

What is the phonological loop of working memory? Visuospatial sketchpad? Central Executive?

Back 30

Phon Loop: Storage of speech material for about 2 secs

Visuospatial sketchpad: visual analog of the phonological loop

Central Executive: allocates mental resources to different tasks (most important but not very understood)

Front 31

What is short-term memory?

Back 31

- Info from Sensory Register selected for further processing is transferred to STM (Paying attention to info is enough to transfer it)

Front 32

How is long term memory stored? (in contrast to STM)

Back 32

LTM differs from STM in four major ways:

1. The form in which information is stored in memory

2. The way in which information is recalled

3. Reasons that forgetting occurs

4. Physical location of these functions in the brain

Front 33

What is procedural memory?

Back 33

"i remember how to play the guitar"

Front 34

What is semantic memory?

Back 34

"i know what a guitar is"

Front 35

What is episodic memory?

Back 35

"i remember buying my first car"

Front 36

What is remote memory?

Back 36

General/biographical info

Front 37

What is retrograde amnesia

Back 37

Refers to the last thing that happened before their accident

Front 38

Damage to memory circuit (prefrontal lobe, amygdala, hippocampus, inferior temporal lobe, thalamus) does NOT produce problems which type of memory?

Back 38

REMOTE (biographical)

Front 39

What's a formal assessment for memory?

Back 39

Wechsler Memory Scale (WMS)

tests:
- auditory immediate
- visual immediate
- immediate memory
- auditory delayed
- visual delayed
- auditory recognition delayed
- general memory
- working memory

Front 40

What formal assessment tests memory in everyday situations?

Back 40

The Rivermead Behavioral Memory Test (RBMT)

Front 41

Convergent thinking

Back 41

recognition of info that is relevant to a central theme or point (or analyzing the available info and concluding what is the main point or idea).
Example: reading an editorial and recognizing
the overall point of view of the editorialist.

Front 42

Divergent thinking

Back 42

the ability to generate a
variety of items or ideas (“animal naming”, multiple solutions to a px); includes thought production and the generation of unique abstract concepts or hypotheses

Front 43

Abstract thinking

Back 43

typically assessed by having
the person explain proverbs or idioms; the ability to transcend the immediate environment, to appreciate different aspects of the situation or problem, and to think symbolically.

Front 44

What are some formal assessments for problem solving and reasoning?

Back 44

1. Ravens Progressive Coloured Matrices

2. Category test

3. Proverb test

Front 45

Whats involved with right hemisphere damage?

Back 45

- Attentional deficits (including orienting)

- Neglect on Left side

- Unawareness of illness

- Visuoperceptual deficits

- Cognitive and communication deficits

- Affective and emotional deficits

Front 46

Whats are some communicative deficits with right hemisphere damage? (7)

Back 46

- Abruptness

- Attentional deficits

- Visuoperceptual deficits

- Lack of self-awareness

- Affective and emotional deficits

- disruptions in forward flow of speech ; word finding difficulties, perfunctory or repetitive

- Prosody and word stress

Front 47

What is anosognosia?

Back 47

Lack of knowledge or awareness of disease

Front 48

When a pt can't learn new information, they have _________ _________.

Back 48

Anterograde amnesia