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Chapter 16

PSYB32H3 Chapter Notes - Chapter 16: Alois Alzheimer, Vascular Dementia, Old Age

Course Code
Konstantine Zakzanis

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Chapter 16 Aging and Psychological Disorders
The general public endorse many mistaken beliefs about the elderly.
The social problems of aging may be especially severs for women\
The physical realities of aging are complicated by ageism, which can be defined as discrimination against any
person, young or old, based on chronological age
16.2 Old age and Brain Disorders
Although the majority of older people do not have brain disorders, these problems account for more admission and
hospital inpatient days than any other geriatric condition
The DSM5 descriptions for dementia, and delirium, are found in the chapter titled "neurocognitive disorders"
According to DSM5, the preferred term instead of "dementia" is "neurocognitive disorders", however the
term dementia was retained in the interests of continuity and the tendency for dementia to be sued in setting
where doctors and patients are familiar with the term
The neurocognitive disorders are being grouped into he diagnostic categories of delirium, mild
neurocognitive disorder, and major neurocognitive disorders
Definition: Gradual deterioration of intellectual abilities to the point that social and occupational functions are
Difficulties remembering things, especially recent events, is the most prominent symptoms
o People may leave task unfinished because they forget to return to them after an interruption
o Hygiene may be poor, and appearance slovenly because the person forgets to bathe, or how to dress
o People may even get lost, even in familiar settings
Judgement may become faulty/ increasing difficulties comprehending situations, and making plans of
They relinquish their standards and lose control of their impulses
During the terminal stages of the illness,
1. The personality loses its sparkle and integrity
2. Social involvement with others keeps narrowing
3. The person is oblivious to his or her surrounding
Cause of dementia
Dementia are typically being classified into three types Alzheimer's disease, the front-temporal dementia, and the
front-subcortical dementias
A// Alzheimer's Disease
It is the most common form of dementia, which accounts for 50-88% of dementia cases in the old people
The disease was originally being described by the German neurologist Alois Alzheimer in 1906 brain tissue
deteriorates irreversibly, and death usually occurs 10 to 12 years after the onset of symptoms
Median survival time is 3.1 for Canadians with AD; while 3.3 for Canadians with vascular dementia
Gender is a factor women live longer than men, but more women than men die as a result of this disease
The person may at first have difficulties only in the concentration and in memory for newly learned material, and
may appear absent0minded and irritable
The shortcomings can be overlooked for several years, but that eventually interfere with daily living
Indeed, well before the onset of any clinical symptoms, subtle deficits in leaning and memory are revealed by
neuropsychological tests
As the disease develops, the person often blames others for personal failings and may have delusions of being
Memories continues to deteriorate, and person becomes increasingly disorientated and agitated

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The main physiological change in the brain, evident in autopod, is an atrophy of the cerebral cortex first the
entorhinal cortex and the hippocamps, and later the frontal, temporal, and parietal lobes
As the neurons are lost, the fissures widen and the ridges become narrower and flatter the ventriculus also
become enlarged
Plagues, small round areas making up the remnants of the lost neurons and beta-amyloid, that are scattered
throughout the cortex
o Beta-amyloid is a waxy proteins deposit
Neurofibrillary tangles, tangled, abnormal protein filaments accumulate within the cell bodies of the
The plagues and tangles are presented throughout the cortex
Since the cerebellum, spinal cord, and motor and sensory areas of the cortex are less affected, therefore Alzheimer's
suffered do no typically appear to have anything physically wrong until late in the course of disease
There is a very strong genetic basis for Alzheimer's
There are recent advances show conclusively that AD is highly heritable but genetically it is quite complex
The project found that by the time the participants reach the age of 80, the children of portents who both
developed AD will themselves have a cumulative risk of 64%,
o The 64% is 1.5 times the level of risk for children with one parent being AD, and five time the level of
risk for children whose parents did not
The genes appears to be related to the development of both plagues, and tangles, and it seems to also increase
the likelihood that the brain will incur damage from free radical
The environmental is also likely to play a role in most cases of Alzheimer's
This is suggested by reports of long0lived MZ twins who are discordant for the disorder
Studies confirmed the role of environmental factors, recognitions of these modifiable factors is important for
those seeking to lessen the incidence and prevalence of Alzheimer's
However, in general, studies conclusively suggest the heritability for Alzheimer's was very high (79%), with it being
quite similar for men and women
Cognitive Reserve Hypothesis, is the notion that high education levels delay the clinical expression of dementia
because the brain develops back or reserve neural structures as a form of neuroplasticity
Bilingual is a related protective factor
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