4 May 2016
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Chapter 18 – Aging and Cognitive Disorders
Old Age and Stress
Old age is usually defined in our society as the years past age 65
oAround 36 million people in the U.S. are “old” – 12% of the population and
growing
oOlder women outnumber men by 3 to 2
Like childhood, old age brings special pressure, unique upsets, and profound biological
changes
The psychological problems of elderly persons may be divided into two groups
Depression Later in Life
Depression is one of the most common mental health problems of older adults
The features of depression are the same for elderly people as for younger people
oAs many as 20% of people experience this disorder at some point during old age
The rate is highest in older women
Several studies suggest that depression among older people raises their chances of
developing significant medical problems
More than half of older patients with depression improve with these treatments
It is sometimes difficult for elderly people to use antidepressant drugs effectively and
safely because the body’s metabolism works different later in life
Moreover, among elderly people, antidepressant drugs have a higher risk of causing
cognitive impairment
Delirium
Delirium is a clouding of consciousness
oAs a person’s awareness of the environment becomes less clear, he or she has
great difficulty concentrating, focusing attention, and thinking sequentially
This leads to misinterpretations, illusions, and, on occasion,
hallucinations
This state of massive confusion typically occurs over a short period of time, usually
hours or days
oIt may occur in any age group – including symptoms – but it is most common in
elderly persons
oDelirium affects fewer than 0.5% of the nonelderly population, 1% of people
over 55, and 14% of those over 85 years of age
Fever, certain diseases and infections, poor nutrition, head injuries, strokes, stress
(including the trauma of surgery), UTIs, and intoxication by certain substances may all
cause delirium
Disorders of Cognition
Cognitive “mishaps” (e.g., leaving without keys, forgetting someone’s name) are a quite
common and quite normal feature of stress or aging
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