CLP 3140 Lecture 19: Chapter 15- Old Age and Disease

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Clinical Psychology
CLP 3140

Chapter 15: Disorders of Aging and Cognition Old Age and Stress - Old age is usually defined in our society as the years past age 65. o 43 million people in the United States (13.6%) - Overall population of the elderly is on the rise. - About half of adults over 65 have two or three chronic illness, and 15% have four or more. - Geropsychology: the field of psychology concerned with the mental health of elderly people o Only 4% of clinicians work primarily with elderly people - The psychological problems of elderly people may be divided into two groups: o Depression, anxiety, and substance abuse disorder o Delirium, mild neurocognitive disorders, and major neurocognitive disorders. Depression in Later Life - The features of depression are the same for elderly people as for young people, including feelings of profound sadness and emptiness, low self- esteem, guilt, and pessimism; and loss of appetite and sleep disturbances. - Overall 20% of people become depressed at some point during old age. o The rate is highest in older women. - Elderly are more likely to commit suicide than young people o Rate of suicide in elderly is more than 16 per 100,000 - Older people who are depressed may be helped by cognitive-behavioral therapy, interpersonal therapy, antidepressant medications, or a combination of these approaches. Anxiety Disorders in Later Life - As many as 11% of elderly individuals in the United States experience at least one of the anxiety disorders. - Rate of anxiety increases throughout old age. - Older adults with anxiety disorders have been treated with psychotherapy of various kinds particularly cognitive-behavioral therapy. Substance Misuse in Later Life - Survey finds that 3-7% of older people, particularly men, have alcohol use disorder in a given year. - Older patients who are instiutioanlized, however, do display high rates of problem drinking. - The latter group typically being abusing alcohol as a reaction to the negative events and pressure of growing older. - Most often misuse of prescription drugs is unintentional. - Research suggests that antipsychotic drugs are currently being given to almost 30% of total nursing homes population in U.S., despite the fact that many of residents do not display psychotic functioning. Psychotic Disorders in Later Life - Some elderly people, through, suffer from schizophrenia or delusional disorder. - Many people with schizophrenia find that their symptoms lessen in later life. - Another kind of psychotic disorder found among the elderly is delusional disorder, in which people develop beliefs that are false but not bizarre. o 2 of every 1,000 people- but its prevalence appear to increase in the elderly population. - Older people with delusional disorder may develop deeply help suspciions of often family members, doctors, or friends- are conspiring against, cheating, spying on, or maligning them Disorder of Cognition - As people move through middle ages, these memory difficulties and lapses of attention increase, and they may occur regularly by age of 60 or 70. Delirium - delirium: a rapidly developing, acute disturbance in attention and orientation that make it very difficult to concentrate and think in a clear and organized manner. o Dx checklist: ▪ 1. Over the course of hours or a few days, individual experiences fast-moving and fluctuating disturbances in attention and orientation to the environment. ▪ 2. Individual also displays a significant cognitive disturbance. - 1% of people over 55 years of age and 14 % of those over 85 years of age. - At least another 10% develop delirium during stay at hospital - 60% of nursing homes residents older than 75 years of age have some delirium - Fever, certain diseases and infections, poor nutrition, head injuries, strokes, and stress may all cause delirium. Alzheimer’s Disease and Other Neurocognitive Disorders - neurocognitive disorder: a disorder marked by a significant decline in at least one area of cognitive functioning. - Major neurocognitive disorder: a neurocognitive disorder in which the decline in cognitive functioning is substantial and interferes with a person’s ability to be independent. o Dx checklist: ▪ 1. Individual displays substantial decline in at least one fo the following area of cognitive function: memory and learning, attention, perceptual-motor skills, planning and decision- making, language ability, social awareness
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