PSYCH 333 1nd Edition Lecture 24 Outline of Last Lecture I ADHD II Autism Spectrum Disorder III Intellectual Disability Outline of Current Lecture II Aging III Neurocognitive Disorders Current 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 that matter 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 damage to 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 injury