Class Notes (806,448)
Canada (492,252)
Psychology (7,600)
PSYB32H3 (614)

PSYB32 - 10.docx

4 Pages
Unlock Document

University of Toronto Scarborough
Konstantine Zakzanis

PSYB32 – 10 Old Age and Brain Disorders  Dementia is progressive – gradual deterioration of intellectual, cognitive and behavioural functions and it always gets worse over time  diagnosing Dementia with one examination is wrong because there needs to demonstrative of deterioration over time  dementia evolves in two different ways: step wise vs. slowly progressive – key in differentiating types of dementia  Slowly Progressive: the cognitive, intellectual and behavioural impairments gets worse slowly over time – there is no dramatic change in function, it is continuous and takes usually 8 – 10 years from first diagnosis to death  Step Wise: person will be functioning at a normal level, but functioning dramatically drops within hours or day because something might have happened (i.e. stroke), and each event will go to drop the functioning level  impairment should result in social or occupational disability, as dementia progresses there is decline in self care  each dementia syndrome has a unique neuropsychological signature – they cannot be determined definitely while the person is still alive  neuropsychological testing is the most sensitive way to differentiate between the dementia syndromes – the types and order of deficits are unique to the dementia  a diagnosis of dementia is clinical, and only at autopsy can it be definitive  dementia is a diagnosis made by ruling out other options because there are no bio-markers  one of the most common forms of dementia id Alzheimer’s Disease  prevalence of AD and other forms of dementia is 8%  confirmed risk factors for AD were a family history of AD, head trauma and lower education  half of Canadians with dementia are institutionalized  there are over 60 000 new cases of dementia per year Alzheimer’s disease  about 50-88% the people diagnosed with dementia have AD  it is estimated that by 2050, there are supposed to 160 million diagnosed with dementia  disease usually begins after 65 years of age, and it is slowly progressive  early onset is more progressive than the late onset that develops after 65  death after 8-10 years of its diagnosis, usually a result of physical decline and independent disease resulting of old age  some of the earlier signs are: forgetfulness, asking same question over and over, naming and stuttering problems  women tend to live longer with AD, but more women die from AD as men die more from the co morbid conditions  when a person is diagnosed with Ad, they are labelled as typical (when the person starts showing signs) then changed to probable (after the person is examined over time to show AD progression and Confirmed (after death and autopsy)  E4 allele is a risk factor of early onset, one increases chance of AD by 40%, two AD prevalence is 90%, but it is not a bio marker, just a sub group  when hallucinations are present in AD they are most commonly a result of medicinal side effects - or they might have “Lewy Body Dementia” fairly new, clinically looks like AD but main differentiating symptom is the presence of hallucinations 1 PSYB32 – 10 Neuropathology of AD  the posterior part of the frontal lobe and the medial/anterior part of the temporal lobe undergo a process called atrophy  Atrophy: when the brain wastes way, which enlarges the sulci  if the temporal lobes are the most effected by atrophy it affects the hippocampus and anthretial cortex which cause memory problems  progression of atrophy accounts for memory loss (temporal), speaking problems (frontal) and spatial navigation (parietal)  neuropathological abnormalities in DAT was first described by Alosis Alzheimer in 1906, he observed memory loss and disorientation in a 51 year old patient  following the patient’s death at 55, an autopsy revealed that filaments with the nerve cells were twisted and tangled (called neurofibrillary tangles)  also seen were plaques – they are deposits of amyloidal proteins that accumulate in the spaces between the cells of the cerebral cortex, hippocampus and other areas of the brain critical to memory  at autopsy, count the number of plaques and tangles in a particular part of the brain – accumulation of the plaques and tangles makes a difference in deficits  there are risk factors that contribute to AD: head injury and depression in relation to cognitive reserve (the notion that high education levels delay the clinical expression of dementia because the brain develops back up or reserve neural structures as a form of neuroplasticity-more interconnectivity)  when someone is cognitively active helps preserve cognitive function and cognitive activity aids with crystallized intelligence(semantics improves over time) but not so much with fluid intelligence (novel problem solving declines over time)  relating to all of this with head injury or depression, there is either an inability or motivation to continue with cognitive ability – fail to use it so gonna lose it quicker  physical activity is shown to be just as effective as cognitive activity for cognitive reserve but problems in elderly due to decreased mobility Neuroimaging DAT  DAT cannot be definitively diagnosed until the patient has died and an autopsy is performed  Advances in neuroimaging techniques (PET, MRI, CT, SPECT) have the potential of diagnosing DAT in live patients  hypometabloism: less blood flow going to some parts of the brain helps in terms of understanding where the pathology is diagnose
More Less

Related notes for PSYB32H3

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.