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Lecture 15

01:830:340 Lecture 15: Late Life and Neurocognitive Disorders

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Rutgers University
Mc Kenna

Late Life and Neurocognitive Disorders Myth of the elderly -will be unhappy -cope poorly with troubles -focus on poor health Myth Debunked -will be unhappy – experience more positive emotions than young people (age 18-30) -cope poorly with troubles – only mild decline with cognitive functioning -focus on poor health and will be lonely – normally older people shift their social circle to smaller groups – family and close friends Problems Experienced by the Elderly (the negative) -physical decline and disabilities -sensory acuity deficits -loss of loved ones -social stress of stigmatizing attitudes toward the elderly (doctors sometime treat older people with less interest – “why spend time with this patient if he’s going to die soon” -cumulative effects of a lifetime of unfortunate experiences. Problems with Medical Treatment of the Elderly -chronic health condition of elderly seldom diminish -polypharmacy(if theyhave multiple medications, theymayforget what the last dose theytook was and may take again and that can cause problems) -most psychoactive drug is tested on younger people  the effects are going to be different with younger and older people  important conduct research on different age group Research Methods in the Study ofAging Age effects: things that they all have in common (e.g. social security) Cohort effects: growing up in a particular time period Time of measurement effects: whatever is going on to the individual’s life when they were measured (their attitudes) Psychological Disorders in Late Life (it can be physical) Some medical problems can mimic schizophrenia: -Cushing’s disease -Parkinson’s disease -Alzheimer’s disease -Hypoglycemia -Anemia -Testosterone deficits -Vitamin deficiencies Other Medical disorders can increase anxiety: -Angina -Congestive heart failure -Excessive caffeine consumption -Can look and feel like panic attacks -Selective Mortality: when they die within the measure or during the study (you might be checking in with them or having a longitudinal study)  you have to do follow up studies, and take the study out (it’s a problem) Neurocognitive Disorders in Late life Dementia – -problems remembering things – most common type of dementia is Alzheimer’s -losing control over impulses -ability to deal with abstract ideas deteriorates – disturbance in emotion is common -likely to show language disturbances – vague patterns of speech (these symptoms come on GRADUALLY over the years) -can withdraw and become apathetic (not too excited about anything in life) Course of Dementia -progressive (doesn’t go away), static or remitting depending on the cause -usually develop slowly over years -subtle cognitive and behavioral deficits can be detected before the person shows noticeable impairment -earlysigns of decline – Mild cognitive impairment (you can be driving and for a second, you can say “where am I” and then it comes back to you) Prevalence of Dementia -not all people with mild cognitive symptoms develop dementia (good news) -people with mild cognitive symptoms only 10% per year will eventually develop dementia -people without mild cognitive symptoms – 1% -worldwide prevalence estimates in 2000-25 million or 0.4% of the population -prevalence increase with advanced age - 1-2% people 60-69 increases progressively to more than 20% ages 85 or older Neurocognitive Disorders in Late Life Alzheimer’s disease -Death occurs within 12 years after the onset of symptoms -brain tissue irreversibly deteriorates (not going to come back) -memory loss – most common -begins with absentmindedness and gaps in memory -hard to find words -eventually interferes with daily living - 1/3 – Full blown de
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