...of all dementias and is the sixth leading cause of death in the United States and is the fifth leading cause among persons age 65 and older” (Heron, 2009). II. Seniors with dementia A. “Dementia is the progressive deterioration in cognitive function - the ability to process thought (intelligence)” (Nordqvist, 2013, pp. 1). “Dementia is a non-specific syndrome in which affected areas of brain function may be affected, such as memory, language, problem solving and attention” (Nordqvist, 2013, pp. 3). Dementia is most commonly seen in the elderly. B. Symptoms include; memory loss, moodiness, and communication difficulty. C. Causes of dementia include; Alzheimer’s disease, stroke, dementia with Lewy bodies, Fronto-temporal dementia, Huntington’s disease, and many other diseases. D. Two main categories 1. Cortical Dementia-“The cerebral cortex is affected. This is the outer layer of the brain. The cerebral cortex is vital for cognitive processes, such as language and memory. Alzheimer's disease is a form of cortical dementia, as is CJD (Creutzfeldt-Jakob disease)” (Nordqvist, 2013, pp. 9). 2. Subcortical Dementia-“A part of the brain beneath the cortex (deeper inside) becomes affected or damaged. Language and memory are not usually affected. A patient with subcortical dementia will usually experience changes in his personality, his thinking may slow down, and his attention span may be shortened. Dementias which sometimes...
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...Prevalence of dementia in elderly patients with hip fracture.PUBMED.GOV Hip fractures occur commonly and are a cause of disability for older adults and lead to increased dependence and requirements for social support. Dementia is one of the possible risk factors for falling and hip fracture, a potential source for complications during surgery and during the postoperative period, difficulties in rehabilitation and a risk factor for hip fracture reccurence. However, in previous studies of hip fracture patients, cognitive status has not been formally assessed during the inpatient stay and diagnosis was based only on previous history. Additionally, no previous studies have compared prevalence of dementia between elderly patients with hip fracture and patients with other surgical pathology. Our aim was to define whether dementia was more prevalent in older subjects with hip fracture than in other elderly patients undergoing surgery. In this study, we prospectively assessed all patients aged 68 and older admitted to our hospital for hip fracture surgery during a one year period and compared them with age and gender matched patients attending other surgical departments. 80 hip fracture patients and 80 controls were assessed for dementia. Dementia was common in both groups, presumably reflecting the advanced mean age of both groups and cognitive deterioration due to hospitalization-status. Dementia was significantly higher in the hip fracture group (85%) compared to the control group...
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...TERMINOLOGY CLINICAL CLARIFICATION • Normal pressure hydrocephalus (NPH) is caused by decrease uptake of cerebrospinal fluid leading to a dilatation of the ventricular system and eventual damage to the adjacent parenchyma causing neurological deficiency 1 CLASSIFICATION • Primary (idiopathic) 12 • Secondary to other diseases such infection,trauma to the brain or brain tumors • Absence of an obstruction of cerebrospinal fluid outflow inside the ventricular system of the brain is a common feature of both idiopathic and secondary normal pressure hydrocephalis 2 • Idiopathic normal pressure hydrocephalus 7 o Affect the elderly • Secondary normal pressure hydrocephalus 7 o Affects all ages DIAGNOSIS CLINICAL PRESENTATION • History o Patients...
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...linebacker, Junior Seau’s suicide. The disease deteriorated his brain and hindered his ability to think logically. Seau is not the only retired NFL player found to have had CTE through autopsy following their death. Mike Webster was the first football player found to have CTE, when scientists found the characteristic buildup of the tau protein in his brain. Another significant find in CTE affected brains such as his, includes the shrinkage of the hippocampus, the part of the brain responsible for memory and thinking processes. The disease was originally noticed in boxers, first being called “punch drunk.” These boxers were described as exhibiting “cuckoo” and “goofy” characteristics. The observation in boxers led to a term meaning dementia of a fighter – “dementia pugilistica” which was later renamed its current name, Chronic Traumatic Encephalopathy, in the 1960s (Saulle 2012). ! It’s been confirmed that the cause of CTE is repetitive head trauma but it is unclear whether or not it can be brought on by a single...
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...Director of Dementia Education Mental Illness Research, Education, and Clinical Center (MIRECC) VA Palo Alto Health Care System Clinical Associate Professor (Affiliated) Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine Speakers • • • • • Allyson Rosen Ruth O’Hara Maya Yutsis Brian Yochim Geoff Kerchner Neurocognitive Disorders • Delirium • Major and Mild Neurocognitive Disorder (NCD) Neurocognitive Disorders (NCD) • Primarily COGNITIVE disorders • Acquired and represent decline (i.e. not developmental) Neurocognitive Disorders • Primarily COGNITIVE disorders • Acquired and represent decline (i.e. not developmental) • Underlying brain pathology • For degenerative disorders monitor consensus guidelines in addition to DSM 5 Updates on Neurocognitive Disorders???? Updates on Neurocognitive Disorders???? NO We can still be Updates on Dementia Neurocognitive Disorders (NCD) vs. Dementia • Dementia typically refers to degenerative d/o in elderly Neurocognitive Disorders (NCD) vs. Dementia • Dementia typically refers to degenerative d/o in elderly • DSM expands category to d/o of younger – E.g. HIV, traumatic brain injury Major and Mild Neurocognitive Disorders (NCD) Major NCD • • • • Significant Cognitive Decline Interfere with independence Not due to delirium Not due to other mental disorder Major NCD vs. Dementia • Can be...
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...Alzheimer's disease is the most common cause of dementia. Research advances have enabled detailed understanding of the molecular pathogenesis of the hallmarks of the disease-ie, plaques, composed of amyloid β (Aβ), and tangles, composed of hyperphosphorylated tau. However, as our knowledge increases so does our appreciation for the pathogenic complexity of the disorder. Familial Alzheimer's disease is a very rare autosomal dominant disease with early onset, caused by mutations in the amyloid precursor protein and presenilin genes, both linked to Aβ metabolism. By contrast with familial disease, sporadic Alzheimer's disease is very common with more than 15 million people affected worldwide. The cause of the sporadic form of the disease is unknown, probably because the disease is heterogeneous, caused by ageing in concert with a complex interaction of both genetic and environmental risk factors. This seminar reviews the key aspects of the disease, including epidemiology, genetics, pathogenesis, diagnosis, and treatment, as well as recent developments and controversies. 100 years ago, Alois Alzheimer gave a lecture at a congress in Tubingen, Germany, on the first case of the disease that Kraepelin some years later named Alzheimer's disease.1 In this single case. Alzheimer described typical clinical characteristics with memory disturbances and instrumental signs, and the neuropathological picture with miliary bodies (plaques) and dense bundles of fibrils (tangles), which we today...
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...Dementia Supporting people with dementia and their carers in health and social care Issued: November 2006 NICE clinical guideline 42 guidance.nice.org.uk/cg42 NICE has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. Accreditation is valid for 5 years from September 2009 and applies to guidelines produced since April 2007 using the processes described in NICE's 'The guidelines manual' (2007, updated 2009). More information on accreditation can be viewed at www.nice.org.uk/accreditation © NICE 2006 Dementia NICE clinical guideline 42 Contents Introduction................................................................................................................................... 4 Person-centred care ..................................................................................................................... 6 Key priorities for implementation .................................................................................................. 8 1 Guidance ................................................................................................................................... 11 1.1 Principles of care for people with dementia ...................................................................................... 11 1.2 Integrated health and social care ..................................................................................................... 17 1.3 Risk factors, prevention and early identification...
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...Dissociative Disorders An Overview The core concept of the Dissociative Disorders is a temporary disruption in the normally integrated functions of memory, identity, or consciousness, leading to amnesia, feelings of depersonalization, or multiple personalities in the same individual. For example, a person’s sense of identity changes along with their memories, feelings, and perceptions. They experience a loss in connections or parts of their identity are buried or compartmentalized. What Causes Dissociative Disorders? These disorders are controversial and their causes are not really known. Core Concepts A temporary disruption in the normally integrated functions of memory, identity, or consciousness, leading to amnesia, feelings of depersonalization, or multiple distinct personalities in the same individual. Key Definitions Anterograde amnesia – the inability to form new memories after the condition producing amnesia occurs. Dissociation – The splitting off of a group of mental processes from conscious awareness. Depersonalization – feeling detached from the self (as if watching ). Derealization – objects suddenly change dimensions, appearance, or location (i.e, one’s home becomes unfamiliar). Identity confusion – Unsure of own identity and who one is. Identity alteration – person’s behavior suggests they have assumed a new identity. Ego-dystonic – Thoughts, affect, and behavior elements of an individual’s personality that are...
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...Mood DISORDERS Mood DISORDERS are defined by the presence of mood EPISODES Types of Mood DISORDERS • depressive (major depressive disorder, dysthymia) • bipolar (Bipolar I/II disorder, cyclothymia) • secondary to GMC, substances, medications _ mood EPISODES represent a combination of symptoms comprising a predominant mood state • types of Mood EPISODES: major depressive, manic, mixed, hypomanic MOOD EPISODES Major Depressive Episode (MDE) A. at least 5 of the following symptoms present for 2 weeks, one of which must be either depressed mood or loss of interest • M ood - depressed • S leep - increased or decreased (if decreased, often early morning awakening) • I nterest - decreased • G uilt/worthlessness • E nergy - decreased or fatigued • C oncentration/difficulty making decisions • A ppetite and/or weight increase or decrease • P sychomotor activity - increased or decreased • S uicidal ideation B. symptoms do not meet criteria for mixed episode C. symptoms cause significant social or occupational impairment/distress D. exclude if substance-induced or due to a GMC E. symptoms not better accounted for by bereavement (a constellation of depressive symptoms meeting criteria for a MDE appearing within 2 months of the death of a close relative) Manic Episode A. a period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week (or less if hospitalized) B. during this period three of the following symptoms (four if mood is only irritable; mnemonic...
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...Psychopathology Specific Learning Disorders Table of contents Index Pages Introduction 3 Diagnostic criteria 4 Aetiology 11 Differential diagnosis 14 Comorbodity 16 Prevalence 16 Prevention and Treatment 17 Prognosis 18 Multicultural factors 19 Social factors 19 Conclusion 20 References 21 Stupid Slow Stubborn A tiny fragment of words used, labels for children and people with specific learning disorders. If only they understood Introduction The most basic definition of a specific learning disorder/disability according to Gould (2005) cited in Rörich (2008) is when a learner has an average to above average intelligence, with normal vision and hearing, and receives the same teaching experiences as other learners his age. He, however, underachieves. He is unable to keep up with his peers and generally cannot cope with the demands of the school (pp16). Margari (2013) defines SLD’s as that which are characterizations of academic functioning that are below the level that would be expected given their age, Intelligent Quotient and grade level in school, and interfere significantly with academic performances or daily life activities that require reading, writing or calculation skills. The gist of it, is that specific learning disorders are neurodevelopmental/cognitive disorders that Hulme and Snowling (2009,pp22) define as “typically characterized...
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...BRIEF REPORTS Greater Risk of Dementia When Spouse Has Dementia? The Cache County Study [See editorial comments by Dr. Peter P. Vitaliano, pp 976–978] Maria C. Norton, PhD,abc Ken R. Smith, PhD,de Truls Østbye, MD, PhD,fgh JoAnn T. Tschanz, PhD,bc Chris Corcoran, ScD,ci Sarah Schwartz, MS,ci Kathleen W. Piercy, PhD,ac Peter V. Rabins, MD, MPH,j David C. Steffens, MD,k Ingmar Skoog, MD, PhD,l John C. S. Breitner, MD, MPH,mn Kathleen A. Welsh-Bohmer, PhD,g for the Cache County Investigators OBJECTIVES: To examine the effects of caring for a spouse with dementia on the caregiver’s risk for incident dementia. DESIGN: Population-based study of incident dementia in spouses of persons with dementia. SETTING: Rural county in northern Utah. PARTICIPANTS: Two thousand four hundred forty-two subjects (1,221 married couples) aged 65 and older. MEASUREMENTS: Incident dementia was diagnosed in 255 subjects, with onset defined as age when subject met Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria for dementia. Cox proportional hazards regression tested the effect of time-dependent exposure to dementia in one’s spouse, adjusted for potential confounders. RESULTS: A subject whose spouse experienced incident dementia onset had a six times greater risk for incident dementia as subjects whose spouses were dementia free (hazard rate ratio (HRR) 5 6.0, 95% confidence interval (CI) 5 2.2–16.2, Po.001). In sex-specific analyses, husbands had higher risks ...
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...PL3236 - Abnormal Unit 3 Notes – Assessment and Diagnosis Term | Info | Intro | * Clinical Assessment - the process of gathering information about a person and his or her environment to make decisions about the nature, status, and treatment of psychological problems * Typically begins with a set of Referral Questions developed in response to a request for help * Determine the goals of the assessment and select appropriate psych tests or measures | Goals of Assessment | * What procedures and instruments to use – age, med condition, and symptoms influence tools – psychologist’s theoretical perspective also affects scope. * Integrate findings to develop preliminary answers – shares this – process sometimes has therapeutic effect – feedback | Screening | * Screening - an assessment process that attempts to identify psychological problems or predict the risk of future problems among people who are not referred for clinical assessment * All members of group are given a brief measure for which some identified cutoff score indicates the possibility of significant problems, e.g. Centre for Epidemiological Studies-D (CES-D) – possibility of depression. * General Health Questionnaire (GHQ) – broad-based – indicates if more thorough evaluation is needed. * AUDIT test – 10-item screen to identify substance abuse * To evaluate usefulness of screening, they must have: * Sensitivity – ability of the screener/instrument to identify a problem that actually exists...
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...716 Index major depressive disorder, brain imaging studies, 70–71 malignant catatonia, 333 malingering, 530–531 ‘manic depressive insanity’, 45 manic states, 250, 253 abnormal beliefs and perceptions, 254 amphetamines and, 266 course and outcome, 274 delusional, 16 in HIV patients, 345 in ICD-10, 42 in old age aetiology, 369 clinical features, 370 treatment, 370 in old age, 369–370 mixed state with depression, 255 sensations in, 6 stroke and, 344 stupor in, 31 manic states, 15–17 Marchiafava-Bignami syndrome, 206, 338 Marijuana Anonymous, 239 marital status, and suicide, 454 masculinity drunkenness and, 428 sense of, 395 Massachusetts Male Aging Study, 402 Massachusetts Women’s Health Study (MWHS), 442 masturbation, 396 McNaughton Rules, 558 McNaughton, Daniel, 558 m-CPP 435 , MDMA (3, 4-methylenedioxymethamphetamine; ‘ecstasy’), 328 medial temporal lobe volume in Alzheimer’s disease, 359 MRI for detecting, 75 medical conditions anxiety disorders in, 170 depression treatment, 521 detection of psychiatric illness, 483 feigned illness, 530–531 mental disorders due to, 327 anxiety disorders, 333 cannabis and psychosis, 330 catatonia, 332 cognitive disorders, 334 delusions, 329 depression and Parkinson’s disease, 332 general principles, 327 hallucinations, 328 mood disorders, 330 personality disorder, 333 psychotic disorder, 328 stimulant psychosis, 329 mental disorders due to, 326–335 relationship to affective change...
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...carried out to enable the diagnosis of these physiological disorders. M1, Asses possible difficulties involved in the diagnosis of the disorders from the signs and symptoms. P1, Parkinson’s disease Nature of disaster Causes, Parkinson’s disease is caused by a loss of nerve cells in the part of our brain and this is called substantia nigra. Also the nerve cells in our brain are responsible for producing a chemical and that is called the dopamine. However the dopamine acts like a messenger between the parts of the brain and then the nervous system that helps to control and to co-ordinate body movements. If our nerve cells gets damaged then the dopamine in our brain is reduced, and this shows that the part of our brain controlling movement will not work as before. It will cause the movements and abnormal to become slow. It is not known why the loss of nerve cells associated with Parkinson's disease occurs, currently; it is...
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...Hyperammonemia Ammonia is a normal constituent of all body fluids. At physiologic pH, it exists mainly as ammonium ion. Reference serum levels are less than 35 µmol/L. Excess ammonia is excreted as urea, which is synthesized in the liver through the urea cycle. Sources of ammonia include bacterial hydrolysis of urea and other nitrogenous compounds in the intestine, the purine-nucleotide cycle and amino acid transamination in skeletal muscle, and other metabolic processes in the kidneys and liver. Increased entry of ammonia to the brain is a primary cause of neurological disorders associated with hyperammonemia, such as congenital deficiencies of urea cycle enzymes, hepatic encephalopathies, Reye syndrome, several other metabolic disorders, and some toxic encephalopathies. Ammonia is a productof the metabolismof proteinsand other compounds,and itis required for the synthesis of essential cellular compounds. However,a 5- to 10-fold increase in ammonia in the blood induces toxic effects in mostanimal species, withalterations in the functionof the central nervous system. Bothacuteand chronic hyperammonemia result inalterationsof the neurotransmitter system. Based onanimal study findings, the mechanismofammonia neurotoxicityat the molecular level has been proposed.Acuteammonia intoxication inananimal model leads to increased extracellular concentrationof glutamate in the brainand results inactivationof the N-methyl D-aspartate (NMDA) receptor.Activationof this receptor mediatesATP...
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