PSYCH 333 1nd Edition Lecture 24 Outline of Last Lecture I. ADHDII. Autism Spectrum DisorderIII. Intellectual DisabilityOutline of Current Lecture II. Aging.III. Neurocognitive DisordersCurrent Lecture- Aging:o Late life. Aging involves inexorable cognitive decline.- Severe cognitive problems do not occur for most.o Mild declines are common. Late life is a sad time and most elderly are depressed.- Older individuals report less negative emotion than younger people.o More brain activation in key areas when viewing positive images. Late life is a lonely time.- Some less likely to develop new friendships.- Social selectivity.o As we age, we focus on the interpersonal relationships thatmatter most to us.o Problems. Problems multiply with age.- Physical decline and disabilities.- Sensory and neurological deficits.- Loss of loved ones.- Social stresses such as stigmatizing attitude towards elderly.- 80% of elderly people have at least one major medical condition. Sleep disturbances increase with age.- Insomnia.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Sleep apnea. Medical treatment.- Chronic problems instead of curable disorders.- Polypharmacy; practice of prescribing multiple drugs to an individual.- Psychoactive drugs usually tested on younger participants.- Neurocognitive Disorder:o Definition; impaired cognition that represents a decline from previous functioning.o Major vs. minor neurocognitive disorder. Cognitive domains.- Attention.- Executive function; planning, organizing, and reasoning.- Language.- Learning and memory.- Visuoperceptual. Functional independence: ADLs and IADLs.o Alzheimer’s disease. Cognitive symptoms.- Diffuse and pervasive memory loss.o Short and long term.- Difficulties with:o Attention (acute and sustained).o Planning and organization.o Complex reasoning.o Judgment and decision making.o Maintaining and following a conversation.o Driving/navigation (visual-spatial abilities).o Disorientation. Behavioral and psychological symptoms.- Perseverative (repetitive) behaviors.- Disturbed sleeping patterns and wandering.- Impairment in activities of daily living (bathing, dressing, eating, etc.).- Emotional lability.- Irritability, low frustration tolerance.- Suspiciousness, possible delusions.o E.g., misplacing items and believing that they were stolen. Risk factors.- Age.- Genes/family history.- Female.- Vascular risk factors.- Depression/stress/caregiver burden.- Head injury.- Smoking.- Sleep disorders. Protective factors.- Education.- Exercise.- Diet/nutrition.- Socialization.- Brain fitness.- Cognitive reserve (e.g. bilingualism).o Frontotemporal Dementia. Loss of neurons in frontal and temporal lobes.- Memory not severely disrupted. Impairment of executive functions.- Planning.- Problem solving.- Goal-directed behavior. Difficulty recognizing and regulating emotion.- Much more profound impact than Alzheimer’s. Caused by multiple genetic pathways.- Pick’s Disease.- High levels of tau proteins.o Vascular Dementia. Typically results from stroke (cardiovascular).- Clot forms and impairs circulation.- Cells die. Risk factors.- Smoking, high LDL, cholesterol, high blood pressure. Symptoms can vary greatly, depending upon location of strokes.o Treatment. Currently no treatment to cure or prevent dementia. Medications can slow progression of symptoms.- Limited efficacy – early on in the disease process.- Antidepressants for treatment of depression.- Antipsychotic medication for treatment of agitation. Psychological treatment.- Support groups for both caregivers and individuals with cognitive problems.- Education.- Structuring the environment/compensatory strategies.- Planning for the future/assistive living.o Prevention and recommendations. Exercise. Healthy diet. Reduce cardiovascular risk factors.o Traumatic Brain Injury. Acquired brain injury which occurs when a sudden trauma causes damageto the brain and disrupts normal function. 2-3 million cases per year in the United States. Estimated cost of $100 billion per year in the US. Who’s at highest risk:- 0-4 year olds, 15-19 year olds, and those older than 65 years old.- Males over female (2:1).- Low SES, unemployment, lower educational level.- Prior history of substance use/abuse. Types:- Closed head injury.- Penetrating head injury.- Diffuse/traumatic axonal injury.- Coup/counter coup abrasions.- Blast TBI. Diagnosis.- Accurate diagnosis requires review of acute injury characteristics.o Glasgow Coma Scale (GCS); eye, verbal, motor tests.o Loss of consciousness (LOC); neurologically-induced LOC, not stress altered-mental status.o Post-traumatic amnesia (PTA); time interval from regaining consciousness to forming new memories.- Diagnosis based on day-of-injury reports and medical records (e.g., ER, paramedics, etc.).- Diagnosis is NOT based on self-report or residual symptoms. Symptoms.- Common symptoms.o Physical; headaches, fatigue, sleep disturbance, sensitivity to light, balance problems, nausea.o Cognitive; decreased concentration and attention span, decreased speed of thinking, decreased working memory/problems processing complex information, difficulties with new learning/recent memories.o Behavioral; irritability, depression, anxiety, and emotional mood swings.- Important to be educated about symptoms.o Moderate/Severe TBI. Most typical cognitive deficits.- Attention and working memory.- Speeded processing.- Learning and memory.- Executive functioning. These deficits are often associated with changes in attention and processing speed. Symptoms and deficits can vary vastly based on location of