Alzheimer's Disease and Cognitive Symptoms

Neuropsychology of Aging

• Chronological age is measured in units of time (months or years) since birth
• Biological age refers to a person's position relative to their lifespan based on organ system function and appearance.
• Functional age relates to a person's competence in executing tasks.
• The third age describes the period between retirement from work and the onset of age-related limitations.
• The fourth age is characterized by cognitive and physical limitations that affect daily functioning.
• Psychological age relates to how well a person adapts to changing conditions.
• Social age reflects societal expectations of behavior and roles for specific age groups.
• The Selective Optimization with Compensation model posits that people adapt throughout life, utilizing existing capacities and developing new strategies to maintain effective functioning.

Models of Ageing

• Processes include selection, optimization, and compensation
• Antecedent Conditions are factors like life development and adaptations, reserve capacity, and loss of function.
• Outcomes are the resulting impact on the individual

Ecological Model of Aging

• The interaction of personal competence and environmental demands results in different levels of adaptation.
• A person with high competence will better adapt to challenging environments.
• Competence includes physical, sensory, cognitive, and social capabilities.
• Aging in the absence of disease is unusual.
• Morbidity refers to illness.
• Mortality refers to death.
• Morbidity does not always lead to mortality.

Biological Theories of Aging

• Primary aging is an unavoidable biological process that occurs universally throughout lifespan.
• Secondary aging results from external stressors or environmental influences.
• Time clock theory suggests cells have a predetermined lifespan regulated by a biological clock.
• Immune theory posits that the immune system's efficiency decreases with age, leading to diminished defense against pathogens.
• Evolutionary theory views aging as a byproduct of natural selection, where age-related changes occur after reproductive capacity has been fulfilled.
• Stochastic theories focus on random damage to vital systems that occurs during the aging process.
• Error theory: Errors at cellular level lead to faulty molecules.
• Wear and tear theory: Gradual decline due to overuse of energy.
• Stress theory: Stress hormones in the body affect the aging process.

Cognitive Aging

• Some knowledge becomes inaccessible, but often well maintained.
• Control processes develop at different ages and decline depending on the brain area involved.
• Cognitive decline varies across aspects, with speed of processing, working memory, and long term memory often showing declines.
• Verbal knowledge can increase with age.
• The Posterior-Anterior Shift in Aging (PASA) and Hemispheric Asymmetry Reduction in Older Adults (HAROLD) are patterns related to age-related functional activations.

Cognitive Decline and Theories

• Sensory deficit theory and resource deficit theories explain that aging causes a reduction in cognitive performance due to losses in attention.
• Speed deficit theory describes how aging slows cognitive processes.
• Dedifferentiation account represents the concept that widespread neural activation can show more difficulty in using specific neural pathways.
• Inhibition deficit theory focuses on the decline of inhibition in the cognitive control of the brain.
• Scaffolding theory proposes that the brain adapts to age-related structural changes by forming new and discarding weaker pathways

Cognitive Impairments in Dementia

• Dementia is a syndrome with progressive deterioration in cognitive function, including memory, language, and judgment. It is usually chronic, caused by damage to the brain due to disease or injury.
• Mild cognitive impairment includes subjective/objective cognitive symptoms that are greater than expected for an individual's age and education but do not interfere with daily activities.
• Diagnostic criteria: Cognitive complaints, presence of one or more cognitive impairment in one or more cognitive domains, maintenance of independence and not demented.

Vascular Dementia

• A type of dementia related to cerebrovascular disease, frequently involving strokes or other damage to blood vessels in the brain.
• Small and/large vessel disease can contribute to white matter lesions and lacunes.
• Manifestations include impairments regarding attention, executive functions (planning, set-shifting, inhibition), language, and visual-perceptual skills.

Frontotemporal Dementia

• A progressive neurodegenerative disease characterized by the early onset of behavioral changes, rather than memory problems.
• The frontal or temporal lobes are the affected areas in the brain.
• Individuals may exhibit behavioral variants, including changes in social cognition, executive abilities, and language abilities.
• Early symptoms include difficulty with language, personality changes, executive dysfunction, and social inappropriateness.

Dementia With Lewy Bodies (DLB)

• A neurodegenerative disorder characterized by the presence of abnormal protein deposits called Lewy bodies.
• Often associated with parkinsonian symptoms such as tremor, rigidity, and slow movement.
• Characteristic cognitive issues include visual hallucinations, fluctuating cognition, and sleep disturbances.

Huntington's Disease

• A genetic disorder that causes progressive neurodegenerative changes in the brain, leading to issues with movement and cognition.
• Repeated CAG nucleotide sequences cause abnormal proteins to build up, leading to the degeneration of brain parts like the striatum.
• Initial symptoms often include abnormal involuntary movements (chorea) and cognitive difficulties.

Delirium

• Temporary mental confusion that develops quickly, often caused by an underlying medical condition.
• Symptoms include attention and awareness impairments, memory problems, disorientation, and perceptual disturbances.
• Predisposing factors (older age and co-morbidities) and precipitating factors like infection, surgery, or medication contribute to the development of delirium.

Caregiver Burden

• Caregiver experience can be significantly impacted by dementia in a variety of ways. Often, this is related to unpredictable behavior and poor health status.

• Caregivers may experience emotional and behavioral stress and changes to their own cognitive and physical health.

• Caregiving also presents considerable social and financial burdens.

• These factors can lead to caregiver burden.

This quiz explores various aspects of Alzheimer's disease, including common neuropsychiatric manifestations, cognitive symptoms, and executive functioning issues. Additionally, it delves into cognitive reserve and emotional recognition related to dementia. Test your knowledge on these crucial topics in neuropsychology.