Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
104 Cards in this Set
- Front
- Back
|
Structures involved in memory + learning |
Hippocampus + temporal lobe: emotion and memory Frontal lobe: working memory, exec function |
|
|
H.M. case |
Anterograde amnesia (no new info) Damage to medial temporal lobe Memory can be selectively affected Working memory and long term memory are v different |
|
|
ECT |
Electroconvulsive therapy aka shock therapy Induces seizures Good for treating depression, but has bad rep Patient under general anaesthesia You lose about an hour of memory (any short term mems in hippocampus are wiped out) |
|
|
Short term memory |
Effortless Residual info of experiences Temporal lobe |
|
|
Working memory |
The scratchpad your mind uses to experience anything Long term to short term via working mem The more you have, the petter your cog. performance Highly correlated with intelligence Limited: about 7 items @ one time Frontal lobe |
|
|
Neurotransmitters |
Dopamine: reward Norepinephrine: directing attention
|
|
|
Neurophysiology --> Networks |
Dorsal Attention Network: - Dopamine, norepinephrine - Deficit --> OCD/anxiety - Frontal lobe - Anterior cingulate Ventral Attention Network: - Sensory info - Occipital lobe - Posterior cingulate Visual Attention Network: - Parietal lobe |
|
|
Memory storage |
We don't know where memories are stored in the brain --> every mem is stored everywhere! This is known as polygraphic storage. |
|
|
Memory formation |
Neurons that fire together wire together When new connections are made: - The synapse becomes stronger - Increased receptor sensitivity - Additional receptors are added - Changes in DNA expression within neurons Karl Lashley: teaching rats, removed parts of brain to locate the memory, could remove almost all cortex and rats could still perform tasks. |
|
|
Cognitive aging model --> Sensory processing |
After 70: Hearing, distance perception, smell, stamina, reaction time, muscle strength decrease After 80: Neural processes in general slow down |
|
|
Cognitive aging model --> Attention |
Before 25: Inhibitory control is maturing After 50: Divided + selective attention decrease ^ Divided: process 2+ responses Selective: focus on one task |
|
|
Cognitive aging model --> Working memory |
Elders experience 10%+ decrease in working mem BUT, wide variability! |
|
|
Cognitive aging model --> Consolidation |
Sleep is required to consolidate memories SMR wave is a 12-15Hz rhythm that occurs when body is relaxed --> humans make this when deeply asleep SMR bursts in cortex causes 2ndary bursts in hippocampus to trigger consolidation |
|
|
Cognitive aging model --> Recall |
Recognition memory: does NOT decline with age! - Material that is meaningful is recalled better than what is meaningless - Maybe elders are even superior Recall declines with age (but only slightly) Multiple choice is recognition, not recall |
|
|
Memory interventions |
1. Sensory: assistive tech, surgical correction 2. Attention: diet and activity, neurofeedback 3. Working memory: Dual-N-Back, meditation 4. Consolidation & recall: sleep management, assistive tech |
|
|
Cognitive impairment |
Normal aging Memory: episodic affected more than semantic Working memory and speed of processing decreases Performance peaks in early adulthood, then slowly declines |
|
|
Brain changes |
Large cell growth in early childhood --> pruning at age 2 Steady growth thru age 9 Fairly steady levels from 18-35 Loss of tissue 25-60 at 0.25% per year Loss of tissue >60 at 0.5% per year |
|
|
Semantic memory |
Memory for facts Disconnected from the moment of learning Shared across people Depends on medial temporal lobe (NOT hippocampus!) |
|
|
Episodic memory |
Memory for events Memory tied to specific time + place From your own perspective Depends specifically on hippocampus |
|
|
Diseases of aging |
1. Alz + related dementias 2. Parkinsonian syndromes 3. Diabetes 4. Cancer |
|
|
Result of early treatment |
Early intervention is KEY --> extends lifetime significantly Brain protection is more feasible as a short term than brain repair |
|
|
Dementia definition |
Acquired syndrome of decline in memory + 1 other cognitive function Sufficient to affect daily life Not explained by delirium or other mental disorder |
|
|
Causes of dementia |
AD/Lewy Body/frontal dementias Vascular disease Parkinson's Huntington's Head injury Medications/alc/toxins Infections (e.g. HIV/syphilis) Depression Autoimmune disorders |
|
|
AD pathology |
Amyloid beta and tau are natural proteins that form in healthy brains, but in AD they're not cleaned up Glycation of them causes them to rip through tissue Tau tangles --> failed communication AD is progressive, irreversible decline Delirium is temporary Sudden onset + sudden decline: not AD! |
|
|
Alz diagnostic criteria (1) |
Cognitive deficits manifested by both: 1. Memory impairment 2. One+ other cognitive disturbance Significant impairment in social functioning Gradual onset, progressive cognitive decline |
|
|
Alz diagnostic criteria (2) |
Cognitive deficits are NOT due to: 1. Other CNS conditions that affect cognition 2. Systemic conditions that cause dementia 3. Substance-induced conditions Deficits don't occur only during delirium Disturbance is not better explained by another Axis I disorder |
|
|
Dementia assessment |
- History (caregivers, physical illness) - Neuro and general physical exam - MMSE - Functional assessment - Lab assessment |
|
|
Genetic factors |
Rare autosomal families with early onset: Mutations cause the disease - Prenesilin genes - APP gene APOE gene --> 5 common genotypes APOE-4 increases risk and lowers onset for AD APOE-4 has some effect in predicting cognitive decline, but not considered a useful predictive test/diagnostic marker alone |
|
|
APOE |
APOE-4 in 20% of US population High E4 increases risk of atherosclerosis Centenarians: High E2, low E4 Alz patients: Low risk: E2/E2 High risk: E4/E4 |
|
|
Early Alz detection |
Changes in QEEG can suggest who declines into dementia High theta low beta = ADHD But if old, this means it will likely progress to dementia 40% have AAMI but only 1% progress to dementia |
|
|
AAMI vs. MCI |
AAMI: - 1 memory test, >1 SD below mean for young person - 1% annual dementia incidence - up to 40% of 65+ population MCI: - 1.5 SD below mean for that age group - 15% annual dementia incidence - 10% of 65+ population |
|
|
Pharmacologic treatments |
Cholinergic drugs: cholinesterase inhibitors --> can cause neuromuscular problems Glutamate blockers: Memantine Antioxidants: vitamin E Anti-inflammatory drugs Hormones Statins (lipid-lowering) Ginkgo biloba Curcumin |
|
|
Neuroimaging & dementia |
MRI or CT used for all dementia patients PET to differentiate AD from FTD (FTD causes no metabolic activity in brain) PET to identify amyloid plaque and tau tangles |
|
|
Potential foods + supplements |
MCT: axona, coconut oil Ketones Vitamin B Reservatrol: anti-oxidant, anti-aging Curcumin (from tumeric) Caffeine (also lowers PD risk) Alcohol in moderation Rapamycin: cleans plaque but does not change memory status |
|
|
Protectors for brain aging |
Estrogen Anti-inflammatory drugs Antioxidants Low fat or low sugar diet Wine (or alcohol) Aerobic exercise |
|
|
Risk factors for brain aging |
Definite: Age Family history APOE-4 gene Diabetes High carb diet Possible: Other genes Head trauma Chronic stress Low education |
|
|
Lifestyle changes to lower Alz risk |
Physical conditioning Stress reduction Healthy diet Cognitive training LCHF diet + exercise reversed AD in 17 patients in UCLA study |
|
|
Physical exercise & dementia |
Active lab animals have more hippocampal memory cells Cardio fitness --> thicker parietal, temporal, and frontal cortical tissue Physically active adults have lower AD risk Aerobic conditioning improves frontal lobe functioning and attention |
|
|
Stress & brain health |
Chronically stressed lab animals have fewer hippocampal neurons and more cog. impairment It can also cause depression (impairs concentration and memory) Injecting cortisol into humans impairs learning + recall Proneness to stress doubles AD risk Hormedic effect: cells respond to stress |
|
|
Healthy brain diet |
Overweight --> increases risk for illnesses that cause small strokes and memory loss Antioxidants and omega-3 fat is associated with better brain health Increase of MCT and ketones Reduction of sugars!!! |
|
|
Mental activity |
"Use it or lose it" theory College grads have lower risk for dementia Leisure activities involving mental effort associated with decreased AD risk Benefits of cognitive training are maintained for years |
|
|
Role of carbs |
Increased AGEs Membrane issues (low cholesterol) Mitochondria issues Glutamate signalling problems Increased oxidation Insulin resistance in neurons |
|
|
Model of successful aging |
Combination of: - Avoidance of disease and disability - High cognitive and physical functioning - Active involvement with society |
|
|
Mental illness among seniors |
Depression (most common) Anxiety (common) Dementia/AD Delirium Parkinson's Alcoholism + drug abuse Paranoid disorders/Schizophrenia |
|
|
Depression among seniors |
Unipolar: most common in old age Bipolar: ranges from depressed to manic (0.1%) Minor or reactive depression: In response to life event which the person cannot cope with (10-30%) Major depression: When psych. symptoms persist for 6+ months (1-4%) Dysthymic disorder: Less acute, but symptoms last longer (2%) |
|
|
Risk factors for depression |
Female Unmarried Comorbidity Cholesterol deficiency Financial strain Family history Lack of social support |
|
|
Geriatric depression rating scale |
Yes/no questionnaire Out of 15 0-4: normal 12-15: severe |
|
|
Suicide among elders |
Elders are at greatest risk for suicide 17-20% of all suicides are by 65+ people Highest suicide rates: while males 85+ |
|
|
Paranoia results from |
Social isolation Sense of powerlessness Progressive sensory decline Problems with normal 'checks and balances' |
|
|
Sexual behavior is affected by |
Physiological changes Personal sexual history Self-esteem Sexual orientation Psychological meaning of sex Chronic illness and physical fitness Physical and social environments Others' attitudes |
|
|
Attitudes that affect sexuality |
Stereotypes, misconceptions, jokes --> women unattractiveness, disabled asexual, lack of energy/sexiness Social acceptance Physical and social environments Importance of physical and emotional interaction |
|
|
Myth of declining sexuality |
Only looked at intercourse frequency Cross-sectional studies: - Cohort effect: sexual conservatism - Participant bias: white, educated, healthy, heterosexual Older people who remain active do not differ in frequency compared to younger selves! |
|
|
Reality of senior sex |
No decline for active elders When partner is available, the frequency of sex is fairly stable Even elders with chronic health problems, depression, cognitive dysfunction etc. can enjoy sex Aging does not change ability or desire to have sex But relationships are more important than sexual activity |
|
|
OKCupid stats |
The older males get, the younger girls they accept Females are fairly stable with their age range Most OKCupid users are 26 Men prefer rougher sex as they age, women are the opposite |
|
|
Women sex changes |
Climacteric: peri-menopause, menopause, post-menopause Hot flashes Urogenital atrophy (thinning of vaginal walls) Hormone replacement therapy: preserve long term health, e.g. bone density Sexupharmaceuticals: BC, HRT, lubrication, libido increase (female viagra) Women have higher libido in 30s than 20s |
|
|
Men sex changes |
Male menopause (viropause): - Starts with sarcopenia (30s, but kicks in fully later) - Drops in testosterone --> less aggressive Erectile dysfunction is #1 reason for no sex DHEA decline: metabolite of sex hormones Sexupharmaceuticals: viagra, vitamin D to keep hormone production up |
|
|
Chronic disease and sexuality |
Prostate enlargement/cancer: erection problems Hysterectomy: instant menopause Arteriosclerosis: affects blood flow--> erection Drugs + alc: no erection Alz: going for the person next door |
|
|
Factors: affection, love, and intimacy |
Past history of sexual activity Availability of partner Others' negative attitudes towards senior sex Physiological/disease related changes Living arrangements Widower's syndrome: sexual dysfunction that happens when mourning dead spouse |
|
|
Facilitating senior sex |
Treatment plans based on open communication Address the importance of touch Physical vs psychological changes Sex education and group discussions |
|
|
AIDS stats |
1 mill. Americans have HIV/AIDS, 24% are 50+ Men are at higher risk (86% of elders with AIDS) AAs and latinos at higher risk (56% of elders with AIDS) Most AIDS from IV drug use (but still considered the "gay disease") Women more likely to get it from men, than men from men Transmission risk: only 1/1000 HIV makes your telomeres look a decade older |
|
|
Undiagnosed HIV/AIDS |
Stereotypes: doctors don't routinely test elders Older people don't report symptoms, attribute them to normal aging Physicians are uncomfortable with the convo topic HIV/AIDS programs for elders are rare Elders are uneducated about AIDS Elders are less willing to get tested |
|
|
HIV/AIDS increase among olders |
After menopause, women don't use condoms Men engage in unprotected sex with people who share needles Growing divorce rates --> more senior unsafe sex 38% of HIV-infected seniors have unsafe sex Elders already have weakened immune system |
|
|
Biopsychosocial meaning of death |
Biological: breath, heart, and brain, and then there is pain Psychological: relationship with body and mind, stages of acceptance Social: cultural meaning of death, interpersonal relations |
|
|
Changing context of dying |
Increased life expectancy Fewer infant/child deaths 2/3 die over the age of 65 Tech to prolong life and control pain Legalization of death decisions 1st year that life expectancy went down! Singularity: reach a point where we can solve everything (2045?) |
|
|
Time of death |
Sudden death Known death -- any time Known death -- anticipated (terminal illness) Awareness context: "understanding between people" - Open - Closed - Mutual pretense |
|
|
Place of death |
Home: - Class and culture differences - Family in charge of routine - Medical equipment changes home Hospital: - Experience structures by hospital protocols - Communication btwn patient, family, and health provider - Family: hope of recovery, decision making, relationship with patient |
|
|
Place of death STATS |
Americans die: 20% in ICU 50-60% in hospitals 25-35% in nursing homes |
|
|
Sustaining life |
CPR (cardiopulmonary resuscitation) Mechanically assisted breathing Artificial nutrition and hydration |
|
|
Cost of EoL care |
The 5% who die each year use 30% of Medicare's budget 80% of EoL costs is for the last month of life Patients who plan with doctors lower costs for final week |
|
|
Pre-death conditions |
Futile care: medical interventions are not recommended when no improvement is expected Persistent vegetative state: permanent and irreversible condition of unconsciousness, complete absence of voluntary action or cognition Minimally conscious state |
|
|
Care of the dying |
Hospice, palliative care, EoL care: - Pain and symptom control - Family as the unit of care - Spiritual care US ranks 9th in world on "quality of death" |
|
|
Advance directives |
Allows you to convey wished when choices can no longer be communicated DNR: do not resuscitate, or allow any life sustaining measure Durable power of health care/attorney: person designated to make healthcare decisions for you |
|
|
Principles of medical ethics |
|
|
|
Health Care Reform in 2010 |
Advanced planning consultations Provide incentives for doctor/patient conversations about EoL Not only terminally ill, but regularly every 5 years Accusations of cost savings and encouraging specific course of care |
|
|
Euthanasia |
The act of killing or permitting death of a hopelessly sick individual in a painless way, as an act of mercy. Active: aka assisted suicide, occurs when doctor, or other person helps the sick terminate his/her life. Passive: involves withholding or withdrawing medical treatment. |
|
|
Assisted suicide laws |
Dr. Jack Kevorkian known as "suicide machine" State by state decisions Oregon has the "Death with Dignity Law" (also Cali recently) Netherlands allows "death without consent" Hemlock society: informal clubs that will help you kill youself |
|
|
Stages of death |
Often not linear! |
|
|
Grief and bereavement |
Somatic distress: tightness in throat, sighing, lack of muscular strength, loss of appetite, empty feeling Intense preoccupation with the image of the dead Accusing sense of guilt Hostile reactions Loss of patterns of conduct |
|
|
The journey of grief |
Reactions of grief vary widely Grief is more severe if death is unexpected Loss --> protest --> despair --> detachment --> recovery |
|
|
Creativity, personality, & intelligence |
Intelligence: - Semantic knowledge - Speed of processing - Working memory Personality: Doesn't really change dramatically Creativity: Changes in type of output, quality, etc. |
|
|
Personality -- The Big 5 |
|
|
|
Changes in The Big 5 |
Conscientiousness: ability to handle tasks + organizational skills grow dramatically in 20s, and continue to grow Agreeableness: warmth, generosity, helpfulness grown in 30s and 40s, due to new work and family commitments Neuroticism: worry and instability decrease with age for women, but not for men Openness: desire to try new experiences declines Extraversion: need for social support declines slightly for women, no change for men |
|
|
Srivastava quotes |
- People were getting better at dealing with the ups and downs of life - They were more responsive and more caring - People are getting better at things as they age - They're not becoming grumpy old men |
|
|
Amygdala activity |
- |
|
|
Happiness across life span |
Personality and coping strategies --> resilience Increased self confidence Long term marriages Involvement with life and living Active coping strategies |
|
|
Positive self-perception |
Self-perception test of 5 items Each point of + self-perception of aging decreased risk by dying of 13% Most positive survived 22.5 years Most negative survived 15 years Not affected by self reported loneliness or health status |
|
|
Self-efficacy |
Achieve high self-efficacy: - Challenge to master - Requires effort - Focus on problem solving - Visualize success - Calm, clear thinking - Persistent - Likely to succeed! |
|
|
Intelligence and aging |
Intelligence is affected by: - Biological and genetic factors - Environmental opportunities Measured by IQ (but fairly invalid) Fluid intelligence: new solutions -- declines Crystallized intelligence: using knowledge -- stable or increases Emotional intelligence General intelligence: Gf, Gc |
|
|
Factors that influence intelligence |
- Biological - Education - Involvement in complex work - Cardio disease and intervention - Sensory deficits - Nutritional deficits - Anxiety - Terminal drop |
|
|
Fluid intelligence |
Logical thinking and problem solving in new situations Independent of past knowledge Peaks in 30s and then gradually declines |
|
|
Crystallized intelligence |
Ability to use skills, knowledge, and experience Relies on accessing info from long term storage Vocabulary and general knowledge Remains stable or increases with age |
|
|
Creativity and aging |
Creative people continue to excel in their jobs until very old age (80-90s) Little-c: everyday prob. solving, ability to adapt to change, lack of this is indicator of mental health issue Big-C: rare, creating something that has a major impact on people Sometimes c --> C This needs productivity and generativity |
|
|
Productivity and creativity --> Lehman |
Peak productivity between 30-45 Peak varies by discipline: - Earlier peaks in science careers and fields depending on imagination and physical ability - Later peaks in fields that depend on experience and diplomacy |
|
|
Productivity and creativity Conclusions |
Rapid increase in creative output Peak in 30s or early 40s Steady decline thereafter Both Lehman and Dennis focused on chronological age using cross-sectional designs |
|
|
Productivity and creativity Problems |
Highly creative artists die before becoming "old" Compositional fallacy: average productivity rates do not describe productivity of individuals in that group (cross sectional) |
|
|
Simonton's model of age and creativity |
Creative potential --> ideation --> elaboration --> creative products
Emphasis on career age, not actual age Productivity is high in later life if you begin later However, some are productive both early and later Model allows for possibility of highly creative elders |
|
|
Productivity and creativity --> Dennis |
Focused on number, not quality, of creative works Steep decline after peak age in arts Decline after peak age in sciences Steady rate of production through late 60s |
|
|
Quantity vs quality |
Equal odds role: Positive relationship between quality and quantity Highly productive older persons have high probs of creating a masterpiece |
|
|
Characteristics of last works |
Artists:
- Eliminate fine detail, more subjective Musicians: - Shorter main themes, simpler melodies Scientists - Novel contributions Stimulated by: proximity to death, desire to leave legacy, positivity bias, gerotransendence |
|
|
Declarative memory |
1. Semantic: unchanged (improved) with aging 2. Episodic: declines with aging --> may not be necessary for continued creativity Overall, declarative memory declines with normal aging, but this is mainly driven by the decline in episodic memory |
|
|
Inhibition |
Lowest inhibition when young (lack of inhibitory interneurons and myelin) Higher inhibition in adults Higher inhibition = higher working memory Inhibition Deficit Theory: Begins to decrease slightly in old age Aging weakens cognitive processes that regulate info entering/leaving WM |
|
|
Creativity & Aging Study |
Intensive participatory art programs Results: - Better health, fewer doctor visits, less meds - More positive responses for mental health measures - More involvement with activities |
|
|
Scaffolding Theory of Aging and Cognition (STAC) |
Number of difference factors influence how you age, and these factors interact with each other Explains why involvement in creative activities may lead to better aging |
|
|
Letter vs. category fluency |
Letter: time limited production of words that begin with a certain letter --> stable with age Category: time limited production of examples of a given category --> declines with age |
