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Lecture 10

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University of Toronto Scarborough
Konstantine Zakzanis

PSYB32 Lecture 10 Aging and Psychological DisordersDementia progressive gradual deterioration of intellectual and cognitive functions as well as behavioural functions does not get better gets worse over time have to demonstrate that there is an impairment over time and not just one examination o Slowly progressive when the cognitive intellectual and behavioural impairments slowly get worse over time continuous deterioration 810 years from first diagnosis to ultimately death o Step wise deterioration when the person will be functioning at a certain level and dramatically drop literally within an hour or days because something might have happened then they will function at that level until something happens and they will drop and this continues step wise o In order to meet diagnostic criteria the impairment must result in some sort of social or occupational disability as the dementia goes on this will become incredibly obvious and will have an impairment even when it comes to selfcare mild cognitive impairment MCI when an elderly individual will not only exhibit the cognitive compromise that comes with aging but a single cognitive impairment that is mild in nature typically memory but it does not impair them in terms of their social and occupational functioning o Each dementia syndrome has a unique neuropsychological signature a dementia syndrome cannot be diagnosed definitively while the person is alive so we never know for sure what the person has neuropsychological testing is the most sensitive to differentiating between dementia syndromes in other words the type of pattern of deficits they display and in what order they deteriorate in are unique to the different dementias we will discuss in frontal lobe dementia one of the first signs are executive deficits or behavioural problems o A diagnosis of dementia is clinical not until autopsy that we can definitively diagnose someone with one of the dementia syndromes o Dementia is a diagnosis made by ruling out thingsAlzheimers Disease o Accounts for about half the patients that are diagnosed with dementia o At the present time there are 266 million persons worldwide diagnosed with dementia which is probably a gross underestimate by 2050 this number is expected to go to 106 million people tsunami of persons that are going to require care in their elder years o Some other early signs are people who will ask the same question over and over again naming problems stutter a bit usually begins at the age of 65 the older you get the more likely it is that you will get Alzheimers Disease women tend to live longer with the disease women are also more likely to die from Alzheimers Disease men are more likely to have comorbid conditions that can kill them often a vascular component to their disease stroke heart attack disease is slowly progressive and not step wise
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