Psy3032 - Abnormal Psychology Week 4A - Late Life Disorders

Front 1

What are the ages of people who are old, young-old, old-old, oldest-old?

Back 1

Old - 65 years and older
Young-old - 65 to 74
Old-old - 75 to 84
Oldest-old - 85 years and older

Front 2

Who experiences negative emotions more, the elderly 60 years and older, or young people aged 18 to 30 years?

Back 2

Elderly

Front 3

What difference in reactions do the elderly have to negative and positive stimuli

Back 3

less reactive to negative and more reactive to positive than younger people

Front 4

Do older people seek more interactions with more people or more intimate interactions with fewer people? What is the term used to describe this phenomenon?

Back 4

More intimate interactions with fewer people

Social Selectivity

Front 5

Do older more have less interest and capacity to have sex?

Back 5

No

Front 6

What percentage of the elderly have at least one major medical condition?

Back 6

80%

Front 7

What happens to the quality and depth of sleep as people age?

Back 7

it declines

Front 8

By age 65 what percentage of people report insomnia?

Back 8

25%

Front 9

What are the two main causes of insomnia in the elderly?

Back 9

1. medication side effects
2. pain

Front 10

Do the rates of sleep apnea increase of decrease with age?

Back 10

increase

Front 11

What type of treatment has been found to reduce insomnia in the elderly?

Back 11

psychological treatment

Front 12

Prescribing multiple drugs to a person is called what?

Back 12

polypharmacy

Front 13

How many medications are prescribed to at least one third of elderly people?

Back 13

5 or more

Front 14

Polypharmacy increase the risk of adverse drug reactions which results in what three things?

Back 14

numerous side effects, toxicity, and allergic reactions

Front 15

What is the main reasons that toxicity and side effects are more common in elderly who take psychoactive drugs?

Back 15

because these drugs are mostly tested on younger people and gauging the appropriate dose for lower kidney and liver metabolisms in the elderly is difficult

Front 16

What is the longest running study of ageing?

Back 16

Baltimore Longitudinal Study of Ageing

Front 17

What is called when people are no longer available for follow-up research because of death?

Back 17

selective mortality

Front 18

What is least prevalent in people 65 years or older?

Back 18

mental disorders

Front 19

What is delirium?

Back 19

a disturbance of consciousness and a change in cognition that develop over a short period of time

Front 20

What is dementia?

Back 20

multiple cognitiive deficits that include impairment in memory

Front 21

What are the three main methodical issues that could help explain the low prevalence of mental disorders in the elderly?

Back 21

1. Selective Mortality
2. Response Bias
3. Cohort Effects

Front 22

Describe six main differences between dementia and delirium?

Back 22

1. Dementia develops over years where delirium is rapid onset
2. Dementia changes in memory where delirium they have trouble concentrating
3. Dementia not explained by another medical condition where delirium is secondary to another medical condition
4. Dementia is progressive and non reversible where delirium fluctuates over the course of a day
5. Dementia cannot be treated where delirium is reversible
6. Dementia risk increases with age where delirium does not

Front 23

Define dementia?

Back 23

A deterioration of cognitive abilities such that social and/or occupational functions are impaired

Front 24

What is a major risk factor for dementia?

Back 24

Mild cognitive impairment

Front 25

What are the three stages of progression in dementia?

Back 25

1. Stage 1 - Mild
2. Stage 2 - Moderate
3. Stage 3 - Sever

Front 26

What symptoms present in Stage 1 Dementia?

Back 26

Difficulty remembering things
Forgetting simple things
Forgetting words for items
Awareness of memory lapses
Mood swings

Front 27

What symptoms present in Stage 2 Dementia?

Back 27

More sever memory impairment
Asking repetitive questions
Difficulty in every day life
Become Messy
Social withdrawal
Recite past often
Personality changes
Inability to recognise familiar people
Socially withdrawn
Sleep disturbances
Loss of inhibition

Front 28

What symptoms present in Stage 3 Dementia?

Back 28

Oblivious to surrounding environment
Unable to care for self
May lose ability to communicate
Sleep often
Often vulnerable to other illnesses

Front 29

What sleep difficulties are often experienced by people with dementia?

Back 29

1. Excessive daytime napping
2. Difficulty falling asleep at night
3. Frequently wake during the night
4. Wake excessively early
5. Sundowning - wake during the night in a confused state

Front 30

What percentage of individuals with mild AD have a sleep disturbance?

Back 30

25%

Front 31

What percentage of people with moderate-sever AD have sleep disturbances?

Back 31

50%

Front 32

What percentage of the population worldwide have dementia?

Back 32

0.4%

Front 33

What are the three main types of dementia?

Back 33

1. AD
2. Frontotemporal
3. Vascular

Front 34

When was AD first identified?

Back 34

1906

Front 35

What insight is gained from the high comorbidity between sleep and dementia?

Back 35

correlational but adequate sleep is required for cognitive functioning

Front 36

What percentage of people with MCI develop dementia?

Back 36

1% per year

Front 37

What is the prevalence of dementai in 60 to 69 years olds and those aged 85 and older?

Back 37

1 to 2% in 60 to 69 years olds
more than 20% in those aged 85 and older

Front 38

What percentage of people with dementai have AD?

Back 38

80%

Front 39

AD is characterised by what symptoms?

Back 39

Absentmindedness
Irritability
Difficulty concentrating
Difficulty with short-term/working memory and learning
Language problems
Word finding issues
Disorientation

Front 40

What percentage of people with AD have comorbid depression?

Back 40

30%

Front 41

What symptom is often common in AD before cognitive deficits become noticeable?

Back 41

apathy

Front 42

What are the two reasons amyloid can build up in the brain?

Back 42

1. overproduction of beta-amyloid, or
2. deficiency in clearing beta-amyloid

Front 43

How long can biomarkers be identifiable before cognitive decline begins?

Back 43

10 to 20 years

Front 44

What are the main two biomarkers are associated with AD?

Back 44

plaques (beta-amyloid) and neurofibrillary tangles (protein tau)

Front 45

How are plaques and tangle measured?

Back 45

Plaques are measured through PET scans
Tangles are measured through cerebrospinal fluid (CSF)

Front 46

Which area of the brain are tangle most dense?

Back 46

hippocampus

Front 47

What is the hippocampus important for?

Back 47

memory

Front 48

What neurobiological changes occur int he brain over time due to the presence of plaques and tangle?

Back 48

loss of synapses for acetycholinergic (ACh) and glutamatergic neurons, neurons begin to die, cortical shrinkage and ventricle enlargement

Front 49

What areas of the brain are not usually affected in AD?

Back 49

Cerebellum
Spinal cord
Motor and sensory areas

Front 50

What percentage of people with AD have brain deterioration that leads to motor deficits?

Back 50

25%

Front 51

What is the heritability of AD?

Back 51

79% heritability

Front 52

What gene on chromosome 19 has been identified as as increasing the risk of AD

Back 52

apolipoprotein E4 or ApoE-4 allele

Front 53

At what age does early onset AD occur?

Back 53

35 years old

Front 54

What is the risk for developing AD if you have one E4 allele? and two E4 allele?

Back 54

one E4 allele 30% risk
two E4 allele 90% risk

Front 55

What percentage of people with AD have one E4 allele?

Back 55

50%

Front 56

What is the major Australian study that is researching dementia biomarkers?

Back 56

Australian Imaging, Biomarkers and Lifestyle Flagship Study of AGeing (AIBL)

Front 57

What risk factors have been identified as increasing the risk of developing AD?

Back 57

Smoking
Being single
Depression
Low social support

Front 58

What risk factors have been identified as decreasing the risk of developing AD?

Back 58

Mediterranean diet
Exercise
Education
Cognitive engagement

Front 59

In what two ways is cognitive engagement protective?

Back 59

1. associated with less build up of beta-amyloid
2. associated with increased cognitive ability

Front 60

What was found in 'use it or lose it' meta analysis study looking at frequent versus infrequent engagement in cognitive activity?

Back 60

frequent cognitive activity is related to a 46 percent decrease in risk of AD compared to infrequent cognitive activity.

Front 61

What is the term for the idea that some people may be able to compensate for AD by using alternative brain networks or cognitive strategies such that cognitive symptoms are less pronounced?

Back 61

cognitive reserve

Front 62

What predicts more decline in cognitive functioning, greater risk of AD and dementia, and a faster progression of AD?

Back 62

a lifetime history of depression

Front 63

What type of dementia causes a loss of neurons in the frontal and temporal regions of the brain?

Back 63

frontotemporal dementia (FTD)

Front 64

What type of memory is affected in frontotemporal dementia?

Back 64

working memory

Front 65

What is the typical onset of frontotemporal dementia?

Back 65

mid to late 50's - mean 52.8 years

Front 66

What is the male/female ratio in frontotemporal dementia?

Back 66

14:3

Front 67

Neural deterioration in FTD predominantly occurs in what two specific areas of the brain?

Back 67

anterior temporal lobe and prefrontal cortex

Front 68

What are the early signs of frontotemporal dementia?

Back 68

changes in personality and judgement

Front 69

Functional impairment in three of what six areas must exist to meet the criteria for frontotemporal dementia?

Back 69

Empathy
Executive functioning
Ability to inhibit behaviour
Compulsive or perseverative behaviour
Hyperorality
Apathy

Front 70

People with frontotemporal dementia show and profound change in emotion that commonly causes what to happen?

Back 70

their relationships to breakdown

Front 71

How long after diagnosis of frontotemporal dementia do people usually die?

Back 71

Within 5 to 10 years

Front 72

What is the prevalence of frontotemporal dementia?

Back 72

Unclear but between 4 to 20%

Front 73

Frontotemporal dementai is typically characterised by dysregulation in what two domains?

Back 73

executive functioning and emotion regulation

Front 74

What type of dementia is caused by cerebrovascular disease?

Back 74

Vascular Dementia

Front 75

What is the most common condition that causes Vascular dementis?

Back 75

a stroke

Front 76

What percentage of people develop vascular dementia in the first year after a stroke?

Back 76

7%

Front 77

The risk factors for vascular dementai are the same as the risk factors for what other disease?

Back 77

cardiovascular disease

Front 78

What are the risk factors for developing vascular dementia?

Back 78

smoking
High cholesterol
Elevated blood pressure

Front 79

Strokes and vascular dementia are more common in what race of people?

Back 79

African Americans

Front 80

Why do symtoms of vascular dementia vary so much?

Back 80

because causes such as a stroke affect different areas of he brain

Front 81

What are the two subtypes of dementia with lewy bodies?

Back 81

with or without parkinsons disease

Front 82

What percentage of people with parkinsons disease develop dementia with lewy bodies?

Back 82

80%

Front 83

Dementia with lewy bodies is more likely than AD to show what symptoms?

Back 83

prominent visual hallucinations and fluctuating cognitive symptoms

Front 84

What is a distinct symptoms of dementia with lewy bodies?

Back 84

intense dreams accompanied by levels of movement and vocalising

Front 85

What are people with dementia with lewy bodies often sensitive to?

Back 85

antipsychotic medications

Front 86

What are the most common diseases and injury can cause dementia?

Back 86

Encephalitis
Meningitis
Syphalis
HIV
Neurological trauma ie TBI
Toxin (lead, substance abuse etc)

Front 87

What is the main effect of medications used to treat dementia?

Back 87

to slow the cognitive decline

Front 88

What is the most commonly used type of medication to treat dementia, and what does it do?

Back 88

Cholinesterase inhibitors, used to interfere with the breakdown of acetycholine.

Front 89

Why do many people discontinue using cholinesterase inhibitors?

Back 89

because they have aversive side effects such as nausea

Front 90

Medical treatment are commonly used to treat what psychological symptoms of dementai?

Back 90

depression, apathy, and agitation

Front 91

Describe the 3 most common psychological interventions for dealing with dementia?

Back 91

1. Therapy to help the carers better cope
2. Exercise to improve cognitive functioning
3. Behavioural approaches to compensate for memory loss, reduce depression and disruptive behaviours

Front 92

How is delirium typically described?

Back 92

as a clouded state of consciousness

Front 93

What are the two most common symptoms of delirium?

Back 93

1. extreme trouble focusing attention, and
2. profound disturbances in the sleep/wake cycle

Front 94

What percentage of people with delirium have delusions?

Back 94

25%

Front 95

How is mood affected in people with delirium?

Back 95

people with delirium have extreme mood swings

Front 96

What causes delirium?

Back 96

1. Drug/medication complications
2. metabolic/nutritional imbalances
3. Infections/fevers
4. Neurological disorders
5. Extreme stress

Front 97

What percentage of delirium is caused by drug or medications complications?

Back 97

40%

Front 98

When are physicians most likely to misdiagnose delirium?

Back 98

When lethargy is present

Front 99

What are the 6 major core features of delirium?

Back 99

1. disturbances in attention and awareness
2. a change in cognition that is not associated with any dementia
3. rapid onset
4. symptoms typically caused by a medical condition
5. fluctuates very rapidly
6. responsive to treatment

Front 100

What are five reasons delirium may be associated with age?

Back 100

1. physical changes later in life
2. increased suseptibility to chronic illness
3. contra-indication of medication
4. greater sensitivity to medication
5. presence of age-related brain atrophy

Front 101

Once the underlying cause of delirium is identified how long does it take for the condition to clear?

Back 101

1 to 4 weeks

Front 102

Older individuals who have depression and GAD, 97%+ have had what?

Back 102

an diagnosis prior to the age of 65

Front 103

What disciplines are involved in the multi-discipline treatment of late life disorders?

Back 103

nursing, psychology, social work, medicine, OT, and pharmacy