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Lecture 9

PSY372 Lecture 9 (March 26, 2014).docx

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Christina Gojmerac

PSY372 Lecture 9 - Normal aging or disease? - MCI o Perform worst than older adults but these people don’t show decline in everyday functioning o MCI is a risk factor for developing dementia; some people may convert over the first year o There are other causes of cognitive impairments  Depression, brain tumours  After these are ruled out, then it’s accurate start point that MCI will lead to dementia - MCI clinical criteria o Observation by themselves or people around them o Be tested and show that they’re impaired on standardized tests (objective) not just basic observations (subjective) o Continuous and progressive decline over time (impairments)  If it’s stable or increases, it may be due to other factors - 2 o Preserved independence for caring oneself  Still can function properly without assistance by others o Can’t be formally diagnosed with dementia - MCI subtypes o Amnestic  Demonstrating deficits in memory while showing preserved cognitive profile (IQ, language, visual processing, executive functioning) o Non-amnestic  Don’t have significant memory problem, but they’re show prominent deficit in other domains like language, or executive functions  Prominent cognitive dysfunction  Could be one area or multiple  Ties to other types of dementia - Beyond MCI: dementia o Umbrella term o Gradual onset of symptoms o May or may not be noticed by person experiencing it but usually by people around them o May or may not show abnormalities on their CT scan (nothing that shows up on the brain) - Dementia clinical criteria o Can’t be explained by other factors such as deliria (urinary tract infection that causes dementia state; but once the underlying reason is treated, they go back to normal); or people with depression and schizophrenia o Documenting objective memory problems o Can’t rely only on that o Impaired in at least 2 domains  Memory + something else (language, spatial processing, executive functions, etc;) - Dementia etiologies o Alzhemiers (50% of most cases) o Vascular (20%) o Frontotemporal dementia  Fascinating; presented much earlier in life (50s-60s); presents behavioural change  Lose ability to properly conduct themselves in social settings • Can’t regulate emotions, lose empathy o Lewy Body  Disturbance of executive functioning; significant fluctuation of emotions  Like Parkinson’s disease (trembling, stoop posture)  REM sleep disorder (could start decades before it’s diagnosed); they act out their dreams (thrashing movements, hitting their partner, fall out of bed, etc;) o Parkinson’s disease  Primary motor problem  Can still show cognitive impairments  Basal ganglia  Subset of people with this disease will develop full blown dementia o Huntington’s disease  Also motor problem o Multiple Sclerosis  White matter changes  Motor symptoms and cognitive problems (varies, depending on lesions in brain) - Alzheimer’s disease clinical criteria o Still not fully understand, so sometimes wrong diagnosis happens when autopsy is done at post mortem and it turns out it’s another stream of dementia o Gradual and slow onset, it’s most likely Alzheimer’s o Clear cut history of things declining over time - Case study o Woman o Instrumental of daily livings (no deficiencies in daily doings) o Can’t come up with words, harder to concentrate, can’t absorb new info, forgetful and misplaces things - 2 o Cognitive profiles and scales o Non-memory tests, she’s performing perfectly fine o Language tasks, she’s performing under average - 3 o She meets criteria of MCI - 4
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