Alzheimer's Disease and Cognitive Symptoms

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Questions and Answers

What is the most common neuropsychiatric manifestation in Alzheimer's disease?

Apathy (correct)

Aggression

Depression

Delusions

How do cognitive symptoms in dementia typically present compared to those in depression?

They improve significantly with medication

They fluctuate daily in intensity

They are reported by others before the patient notices them (correct)

They are easily recognized by the patient

Which statement correctly describes the onset and progression of dementia?

Symptoms only worsen without any stable phases

Symptoms develop gradually over many years (correct)

Cognitive decline occurs in short phases

Symptoms appear suddenly and are reversible

What is a key characteristic of apathy in Alzheimer's patients?

It can be mistaken for depression Signup and view all the answers

In terms of executive functioning, what cognitive issue is commonly seen in the early stages of Alzheimer's?

Diminished attention and distractibility Signup and view all the answers

What does cognitive reserve refer to?

Individual differences in cognitive processes or neural networks that allow coping with brain structure decline. Signup and view all the answers

Which group is likely to demonstrate a decline in cognitive performance earlier relative to brain structure decline?

Individuals with a low level of education. Signup and view all the answers

What factor has a significant influence on cognitive performance according to the content?

Age. Signup and view all the answers

How is a score considered 'impaired' in the context of cognitive performance?

When it is 2 Standard Deviations below the average of the normative data sample. Signup and view all the answers

In terms of emotional recognition, which statement is correct?

Women are generally better at recognizing fear, anger, and sadness than men. Signup and view all the answers

Which type of behavioral change is associated with orbitofrontal lobe dysfunction?

Aggressiveness Signup and view all the answers

What characterizes primary progressive aphasia during the first two years of the disease?

Impairment in language Signup and view all the answers

What do individuals with semantic dementia struggle with the most?

Category fluency tests Signup and view all the answers

Which type of frontotemporal lobar degeneration is associated with TDP-43 protein inclusions?

FTLD-TDP Signup and view all the answers

Which symptom may not be present until later in the disease progression of specific dementias?

Behavioral changes Signup and view all the answers

What is a common dietary change observed in some individuals with frontotemporal dementia?

Craving for sweets Signup and view all the answers

What cognitive functions remain relatively intact during the initial stages of certain dementias?

Explicit memory Signup and view all the answers

What is a typical change in behavior observed in individuals with right hemisphere dysfunction?

Dramatic changes in beliefs Signup and view all the answers

What is meant by normative aging?

Aging that reflects a usual, normal, or average outcome Signup and view all the answers

What does the hypothesis of 'compression of morbidity' suggest?

Longer lifespans result in more years of good health Signup and view all the answers

Which brain region shows the steepest rate of volume reduction with aging?

Frontal lobes Signup and view all the answers

What is the primary characteristic of positive aging?

Finding happiness despite challenges Signup and view all the answers

In terms of white matter loss in the brain, which region experiences the greatest decline?

Frontal regions Signup and view all the answers

What aspect of cognitive function typically remains stable with aging?

Crystallized pragmatics Signup and view all the answers

How does the stress system of an older organism compare to that of a younger organism?

It takes longer to return to normal levels Signup and view all the answers

What aspect is commonly associated with successful aging?

Maintenance of physical and cognitive functions Signup and view all the answers

Which of the following is a characteristic of mild cognitive impairment (MCI)?

Cognitive symptoms greater than expected for age Signup and view all the answers

What is the primary risk factor for developing dementia?

Age Signup and view all the answers

Which subtype of mild cognitive impairment is more likely to progress to Alzheimer's disease?

Multiple domain MCI Signup and view all the answers

Which of the following is a metabolic feature that can lead to cognitive impairment?

Thyroid dysfunction Signup and view all the answers

How long is the average life span after an Alzheimer's diagnosis?

10 years Signup and view all the answers

Which condition is characterized by progressive memory impairment and often includes visuospatial and language impairments?

Alzheimer's disease Signup and view all the answers

What typically occurs in the preclinical stage of Alzheimer's disease?

Brain changes happen without measurable symptoms Signup and view all the answers

In Alzheimer's disease, the formation of which protein is associated with pathology?

Beta amyloid protein Signup and view all the answers

Which cognitive function shows the least decline with aging?

Verbal knowledge Signup and view all the answers

What does the PASA pattern of age-related functional activations indicate?

Increased activation in anterior areas and decreased in posterior areas Signup and view all the answers

How do control processes develop and decline with aging?

Decline is differential depending on the brain areas involved Signup and view all the answers

In terms of neural activity, what effect does aging have?

Both increases and decreases of neural activity Signup and view all the answers

What does the HAROLD pattern suggest regarding brain hemisphere activity in older adults?

A shift to more bilateral activity in the brain Signup and view all the answers

Which theory suggests that sensory processing deficits contribute to cognitive decline in older adults?

Sensory Deficit theory Signup and view all the answers

What cognitive function typically declines more than short-term memory with aging?

Long-term memory Signup and view all the answers

Which of the following describes an effect of aging on processing speed?

Processing speed declines with age Signup and view all the answers

Study Notes

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.

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Description

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.