April 2nd, 2013
April-02-13
1:07 PM
Make sure to know lots about the Parkinson's section and schizophrenia
Normal aging and cognition
Associated with specific deterioration rather than general slowing of every skill
The prefrontal regions are most susceptible to reduced blood flow
o Over time certain areas (prefrontal area worst) see decreased levels of blood flow, and the
deprivation of oxygen causes cells to die
Recognition memory stabilizes during normal aging
Recall memory tends to decline
Delay the effects of aging on the brain
Staying in a mentally stimulating environment
o The mechanisms not known, but likely the elaboration of dendritic branches and synaptic
connections
Aerobic exercise
o Vascular proliferation, prevents hypertension and diabetes
Psychometrics are key to measuring abnormal test scores
Used to determine if cognitive deterioration is taking place
Most are standardized on same-age same-sex peers
Standardization of scores
The raw scores on a particular test decline as we age
o They are relative to your age, sometimes also sex and education
Block design on the weschler test
o The amount of time taken to match the picture is recorded
o For 22 year olds, mean is 45-48
o For 52 year olds, mean is 38-41
o For 72 year olds, mean is 29-31
Comparing across domains
Memory, intelligence, attention, spatial skills, language
For the most part, we do more or less the same on all the tests we do
o But usually vary within one standard deviation of our other domains (33% of people do)
When do clinicians start to diagnose problem
To have cognitive complaints, one domain as low as 1.5sd below average, but no interference with
daily life
o These people have mild cognitive impairment
Has a prevalence after 70 years of age
The risk of progression to dementia is 10x higher in these persons
But not all persons with MCI progress any further Profile of results on neuropsychological tests in 65 year-old complaining of forgetfulness
Most cognitive domains are normal
But memory is 2 standard deviations below the mean, so borderline
This individual would likely be diagnosed with MCI, not dementia
Organic dementia can not be explained by normal aging
In normal aging, the slope of the decline of cognitive function is relatively gradual
In people starting with MCI, gradual sl
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