AE3 wk 2 notes.docx - A&E III WEEK 2 THE 3 D’S – DEMENTIA DELIRIUM DEPRESSION 26 SEPTEMBER 2019 Changes in an Aging Brain Certain parts of the brain

AE3 wk 2 notes.docx - A&E III WEEK 2 THE 3 D’S –...

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A&E III WEEK 2: THE 3 D’S – DEMENTIA, DELIRIUM, DEPRESSION 26 SEPTEMBER 2019 Changes in an Aging Brain - Certain parts of the brain shrink, especially the prefrontal cortex (an area at the front of the frontal lobe) and the hippocampus - Changes in neurons and neurotransmitters, and brain’s blood vessels - Damage from free radicals and inflammation increases - Growing evidence of the adaptive capabilities of the brain of older adults - Memory loss is not a normal part of the aging process DEMENTIA - A general term to describe: o Change in mental ability severe enough to interfere with daily functioning o Memory loss + other cognitive decline o A person with dementia has both a chronic illness and a terminal illness - Not really a diagnosis - There are over 100 different causes of dementia o Alzheimer’s Disease = accumulation of amyloid plaques between nerve cells (neurons) o Lewy Body Disease = deposits of protein alpha-synuclein in the brain o Vascular Dementia = caused by major stroke or multiple minor strokes o Frontotemporal = progressive nerve cell loss in the frontal lobes o Normal Pressure Hydrocephalus (NPH) = accumulation of CSF - Diagnostic criteria for Dementia (as per DSM V): o A decline in memory and at least one of the following: Ability to generate coherent speech and understand spoken or written language Ability to recognize or identify objects (assuming an intact sensory function) Ability to execute motor activities (assuming intact motor and sensory abilities, and comprehension of task)
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Ability to think abstractly, make sound judgments, and plan and carry out complex tasks Mild Cognitive Impairment (MCI) - Generally independent in ADLs although there may be a decline in performance - Is often prodromal stage of dementia - Older patients with MCI and are depressed have a greater risk of developing Alzheimer’s Disease - Early Signs of Cognitive Decline? o Gait changes - cognitive-decline-and-alzheimers-are-seen-in-gait.html o Personality changes - checklist-mild-behavioral-impairment.html o Hypersexuality/sexual craving - mothers-extramarital-cravings-are-linked-to-dementia.html Assessment of Cognitive Function - Reasons o Screening o Monitoring - How to Assess Cognitive Function o Mini-Mental State Exam (MMSE) o Mini-Cog - When to Assess Cognitive Function - Diagnostic Tests - 10 Warning Signs of Alzheimer’s Disease o Memory loss that disrupts daily life o Challenges in problem solving o Difficulty completing familiar tasks o Confusion with time or place o Trouble understanding visual images o New problems with words o Misplacing things o Decreased or poor judgment o Social withdrawal o Changes in mood and personality The Mini Cog - 1. Instruct the patient to listen carefully to and remember 3 unrelated words and then to repeat the words.
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  • Summer '17
  • Laurei Jeffers

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