Cognitive Disorders and LifeSpan Issues

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Chapter 14

• Cognitive Disorders and Life-Span Issues

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Geropsychology

• Definition Study of psychological disorders and
  difficulties in late life.
• Late life associated with many biological,
  psychological, and social changes.
• As a result, later in life, individuals may be at
  greater risk for disorders (e.g., anxiety
  disorders, depression, substance use disorders),
  as well as disorders unique to geriatric
  populations.

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Cognitive Disorders Dementia

• Most commonly occurs later in life.
• Prevalence increases with age.
• Seeing higher and higher rates of dementia due to
  the simple fact that people are living longer.
• Also due to our increased understanding of the
  effects of certain medical conditions, such as
  Alzheimers Disease.

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Dementia Symptoms

• Memory Impairment (required for a diagnosis)
• Aphasia (difficulty producing names of objects or
  people)
• Apraxia (impairment in the ability to execute
  basic actions)
• Agnosia (Failure to recognize or identify
  objects)
• Disturbance in executive functioning
  (difficulties planning, organizing, abstraction,
  etc).

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Dementia

• Most commonly caused by Alzheimers Disease.
• Accounts for over 50 of dementia cases.
• Begins with mild memory loss (e.g., word finding
  problems, etc.) and progresses to severe memory
  loss and disorientation.
• Usually begins around the age of 65.

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Alzheimers Disease

• Filaments within nerve cells become tangled
  (neurofibrillary tangles).
• These tangles interfere with the basic
  functioning of neurons.
• Amyloid Plaques Protein deposits that accumulate
  in spaces between cells of the cerebral cortex,
  hippocampus, amygdala, and other areas of the
  brain central to cognitive functioning.
• Results in tremendous cell death in the cortex of
  the brain and destruction of dendrites
  (connections between neurons)

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1 2
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• Healthy brain of an individual who died near the
  age of 100.

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• Brain of an Alzheimers patient.

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Other causes of dementia

• Stroke
• Vascular dementia
• Head injuries
• Parkinsons disease
• HIV
• Huntingtons disease

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Delirium Symptoms

• Characterized by disorientation, recent memory
  loss, or clouding of consciousness
• Disturbance of consciousness (e.g., inability to
  focus attention, lack of awareness of immediate
  environment)
• Change in cognition (memory deficits,
  disorientation, etc.)
• Develops over a short period of time.
• Caused by the direct physiological consequences
  of a medical condition.

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Causes of delirium

• Dementia is the strongest predictor of delirium
• Intoxication
• Other medical conditions (e.g., Alzheimers,
  Parkinsons, HIV, infection)
• Associated with a high mortality rate (due to the
  underlying cause of the delirium usually being
  quite severe).

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Other disorders

• In elderly, we see a rise in anxiety disorders,
  depression, and substance use disorders (mostly
  alcohol and prescription medication abuse).
• Differential diagnosis between depression and
  dementia can be difficult
• In depression, cognitive deficits less severe
• Non-cognitive symptoms of depression more severe
• Dont have problems with recognition
• Rapid onset of symptoms in depression.
• Treatments focus heavily on quality of life