Textbook Notes (270,000)
CA (160,000)
UTSC (20,000)
Psychology (10,000)
PSYB32H3 (1,000)
Chapter 16

Chapter 16 Notes


Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis
Chapter
16

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Chapter 16
-Ageism- discrimination against any person, young or old, based on chronological age-when old
people are stigmatized for being old- ignores the diversity among people in favour of employing
stereotypes
-Dementia is a progressive disorder
-There have been some new programs put forth to help elders recently and because of the rise of the
baby boomers that will be aging, these programs are important as well as preventive interventions
and coefficient treatments
-There has been some education for health professionals while they study, about geriatrics but there
are still few people committed primarily to their needs- doctors cant identify older patients with
psychological problems, and can identify younger patients better- less likely to refer the patient for
psychological help or treatment and they said psychotherapy was less effective for older patients
-Old= people over 65
-Young old- 65 to 74
-Old- old- 75- 84
-Oldest- old- 85 years and older
-The people 65 years and older are increasing over the years, the old- old is growing by 3.5% per year
-Age effects- consequences of being given a chronological age
-Cohort effects- consequences of having been born in a given year and having grown up during a
particular time period with its own unique pressures, problems, challenges, and opportunities
-Time- of – measurement effects- confounds that arise because events at an exact point in time can
have a specific effect on a variable being studied over time
-Cross- sectional studies- investigatore compares different age groups at te same moment in time on
the variable of interest- statements about age effects in a particular study
-Longitudinal studies- select one cohort and periodically retests it using same measure over a number
of years- allows to trace individual pattenrs of consistency or change over time- cohort effects- and
analyze how behaviour in early life relates to behaviour in old age- BUT there is often selective
mortality with this- participants often drop out- the people left are usually healthier
-DSM- IV assesses adults and elders relatively the same but its hard to determine whether symptoms
are physiological or psychological
-Measure of cognitive functioning is often included in practise to determine whether they have
impaired cognition
-Mini mental state examination- MMSE- brief measure of individual’s cognitive state, orientation,
memory, and attention.. ability to name, follow verbal ad written commands, write a sentence
spontaneously and copy a complex polygon
-Simple measures like drawing the hands of the clock can tell if they have Alzeimers or dementia
-Different assessments for the elderly to see depression or other thoughts that elerly have
-Elderly people suffer from being old and being mentally ill- double jeopardy
-DEMENTIA- GRADUAL DETERIORATION OF INTELLECTUAL ABILITIES TO THE POINT
THAT SOCIAL AND OCCUPATIONAL FUNCTIONS ARE IMPAIRED- difficulty remembering
things, especially recent events, is more prominent symptoms
-There is no coming back from a dementic disorder; the syndrome cannot be diagnosed on the first
occasion you see a patitent
-As noted by the DSM, we have a set of diagnostic criteria
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-We see the person over time gradually
-We have to see the progressive deterioration, and later on we will see progressive neurobiological
deterioration
oForget to do things, forget names of children, poor hygiene, forget how to bathe or dress, get
lost in familiar settings
oFaulty judgment and difficulty in comprehending situations and making decisions
oLose control over their impulses, use coarse language, inappropriate jokes, or shoplift
oAbstract thinking, and disturbances in emotion, depression, flat- affect, sporadic emotional
outbursts
oLanguage disturbances, vague patterns of speech
oDifficulty in motor activities, such as doing ADLs and IADLs
oTrouble recognizing familiar surroundings, and DELIRIUM MAY OCCUR
oMay be progressing, static, remitting, depending on the case- people with progressive
demetia may become withdrawn and apathetic, personality loses its sparkle, not theirself
anymore, social involvement lessens, oblivious to surroundings
oPREVALENCE INCREASES WITH ADVANCING AGE
oThe numbers of people with alzheimer’s will be increasing in the years to come
-Some may have early memory problem,s and others may have motor problems; by way of
addressing these neuropsychological symptoms, one can diagnose these symptoms
oMemory
oNaming deficits; visual spacial impairments
Four major goals of the Canadian Study of Health and aging:
1) to use a common research protocol to estimate prevalence of dementia in Canadians age 65 and
older: 8 PERCENT IN CANADA, theres 16.8 percent over 65 tha have cofnitive impairment but no
dementia- cognitive impairment in absence of dementia – SUBCLINICAL DEMENTIA, still
involves the need for institutional care and subclinical dementia predicts negative outcomes such as
death and dementia over 5 years
2) identify risk factors associated with AD- confirmed risk factors for Ad was FAMILY HISTORY OF
AD, HEAD TRAUMA AND LOW EDUCATION
3) examine patterns of caring for Canadians with dementia- HALF DEMENTIAS ARE IN HOSPI
0TAL AND HALF ARE IN COMMUNITY RESIDENTS- WIVES CARRY OUT CARE IN
COMMUNITY AND DAUGHTERS CARRY OUT CARE IN HOSPITALS
4) develop uniform database for subsequent longitudinal investigations- THERE ARE OVER 60 000
NEW CASES OF DEMENTIA EACH YEAR
5) HAVING GREAT CHRONOLOGICAL AGE, LOWER MMSE SCORS AND IDENTIFICATION
OF MEMORY DIFFICULTIES BY CAREGIVERS ARE RISK FACTORS FOR DEMENTIA
Causes of Dementia-
oAlzheimer’s disease
Accounts for 50% of dementias in older people- 1/13 people over 65 have dementias
Brain tissue deteriorates irreversibly, and death usually occurs 10-12 years after
symptoms start
Women with AD live longer than men with AD but die more than man with AD
Concentration, memory loss, irritable, interferes with daily living
Deficits in learning and memory are there for people who will later develop the
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disease
Then they blame others of personal failings and have persecutory delusions
Memory deterioration and increasing disorientation and agitation
ATROPHY OF THE CEREBRAL CORTEX- FORST OF THE ENTORHINAL
CORTEX AND THE HIPPOCAMPUS AND THEN OF FRONTAL, TEMPORAL,
AND PARIETAL LOBES BECOME FLATTER
ENLARGED VENTRICLES
PLAQUES- SMALL AREAS COMPRISING THE REMNANTS OF LOST
NEURONS AND B- AMYLOID, A WAXY PROTEIN DEPOSIT- SCATTERED
THROUGH CORTEX
NEUROFIBRILLARY TANGLES- ACCUMULATION IN CELL BODIES OF
NEURONS
PLAQUES AND TANGLES ARE PRESENT IN CEREBRAL CORTEX AND
HIPPOCAMPUS
Volume loss in HIPPOCAMPUS, causing episodic memory impairment, but people
with AD for four or more years have volume loss in TEMPORAL LOBES was those
in older years
Cerebellum, spinal cord and motor and sensory areas of cortex are less affected which
is why AD patients don’t appear messed at first sight
Neurons are also lost in the nigrostriatal pathway
CELL DIES WITH AMYLOID BUILDUP IN IT, NEUROFIBRILLARY
TANGLES ARE ASSOCIATED WITH CHANGES IN TAU PROTEINS WHICH
ARE CURC IAL FOR MAINTAINING TRANPOSRT IN NEURONS- TANGLES
ARE MORE SPECIFIC WITH AD
LACK OF ACETYLCHOLINE- people taking medications that lower Ach, have
symptoms like in AD, there arew few Ach terminals in their brains and major
metabolites of Ach are low and are associated with greater mental deterioration
GENETICS PLAYS A LARGE role- MZ twins have higher chance of getting it,
people with two parents with AD have 5 times higher chance of getting it than people
with no parents with it
Chromosome 21 that has to do with down syndrome carries the gene controlling the
formation of b- amyloid- this causes early onset of AD
There are also genes on chromosomes 1 and 14 that account for 75% of early onset of
AD- THESE GENES ACTUALLY CAUSEEEEEEEEE!!!!! THE ONSET
The Apolipoprotein E4 allele on chromosome 19 increases THE CHANGE OF AD
BY 50% AND HAVING TWO ALLELES BRINGS RISK TO 90%, - RELATED
TO FORMING PLAQUES AND TANLGES AND INCREASES LIKELIHOOD
THA BRAIN WILL INCUR DAMAGE FROM FREE RADICALS
LOWER EDUCATION IS A RISK FACTOR, HISTORY FO HEAD INJURY,
DEPRESSION, INCREASE RISK
NSAIDs, such as ASPIRIN helped to reduce risk and so does nicotine
Remaining active at cognitive level may buffer or protect individual in terms of
degree of cognitive decline experienced, as well as having high level of cognitive
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