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Questions and Answers
What physiological response tends to be more challenging for older adults compared to younger adults in stressful situations?
What condition is more commonly experienced by older adults compared to depression?
What is one of the physical symptoms older adults exhibit when experiencing depression?
Which factor is identified as increasing the risk of depression in older adults?
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How do older adults generally experience positive and negative emotions compared to younger adults?
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What common factor may lead to anxiety in older adults?
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Which of the following symptoms is NOT typically associated with depression in older adults?
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What is the most common response of older adults to chronic and unpredictable stressors?
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Which of the following strategies are included in memory training for improving verbal episodic memory?
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What is the primary focus of reasoning training according to the content?
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How did the speed of processing training improve cognitive abilities?
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What was a notable outcome of the cognitive training interventions after 10 years?
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Which factors could potentially affect cognitive training effectiveness in older adults?
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Which of the following interventions aims to address ageist attitudes?
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Which cognitive ability was specifically tested through tasks involving letter or number series?
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What is a characteristic of the speed of processing training interventions?
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Which strategy is NOT recommended for enhancing attention in clients with cognitive changes?
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What type of memory technique involves logical grouping of information to aid learning?
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Which aspect of cognitive function is significantly impacted by aging?
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Which intervention strategy helps improve working memory?
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What is a recommended strategy to improve cognitive flexibility?
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Which change is associated with decreased speed of information processing in older adults?
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Which strategy is NOT effective in promoting memory retention?
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What technique can help with retrieval of information from working memory?
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Which component of cognitive function is primarily linked to executive functioning?
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Which of the following interventions helps effectively reduce anxiety and improve cognitive processing?
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Study Notes
Memory Training
- Teaches mnemonic strategies for remembering
- Includes instruction in strategy and mnemonic rules
- Uses word lists, sequences of items, grocery lists, text material
- Focuses on main ideas and story details
- Offers individual and group feedback on performance
Reasoning Training
- Focuses on the ability to solve problems that follow a serial pattern
- Includes identifying patterns in letter or number series and everyday activities
- Includes abstract reasoning tasks and reasoning problems related to activities of daily living
- Uses individual and group exercises
Speed of Processing Training
- Focuses on visual search skills
- Uses gradually complex speed tasks on a computer
- Decreases stimuli duration
- Adds distractions
- Increases the number of concurrent tasks
- Presents targets over a wider spatial expanse
ACTIVE Study Results
- 2 Years: Each intervention improves targeted cognitive ability compared to baseline and lasts up to 2 years
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10 Years: Participants in each intervention group report less difficulty with IADLs, memory, and reasoning
- 60% of trained participants report being at or above baseline level for self-reported IADL function (compared to 50% of controls)
- Reasoning and speed-of-processing interventions maintain effects on targeted cognitive abilities
Implications for OT Assessment and Intervention
- Less energy with older age makes it more difficult to keep up with learning activities, leading to exhaustion
- Family routines, such as caring for grandchildren and pets, can cause caregiver stress due to family expectations and cultural factors
- Ageist attitudes can affect an individual's self-perception
Intervention Strategies
- Education: Provide education about self-attitudes
- Energy Conservation: Teach energy conservation techniques
- Family Involvement: Involve family in planning daily routines and understanding cultural influences
Communication
- Promotes social interaction
- Ensures safety
- Addresses occupational performance
Interventions for Sensory Loss
- Setting Cues: Establishes cues for clients
- Sensory Prevention: Implements strategies to prevent sensory overload
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Adaptation: Adapts tasks and tools
- Adjust font size, use magnifying glasses
- Education: Educates clients and family on safety
- Advocacy: Provides advocacy for clients
- System Navigation: Assists with navigating systems and accessing resources
Age-Related Cognitive Changes
- Cognitive changes are a major threat to participation and quality of life
- Not all cognitive abilities decline with age
- Life experience can compensate for declines associated with memory impairment
- Understanding patterns of preserved and impaired cognitive functions helps understand the impact on occupational performance
OT Goals
- Promotes cognitive health
- Assists clients in understanding cognitive changes
- Develops strategies to enhance functioning
Cognitive Changes: Arousal and Sleep
- Frontal lobe changes affect arousal and sleep patterns
- Increase in sleep duration
- Sleep disturbances are associated with:
- Depression
- Alzheimer's Disease
- Cardiac, respiratory, and musculoskeletal conditions
- Sleep disturbances impact cognitive functioning
Cognitive Changes: Intellectual Changes
- Crystalized intelligence: Remains intact
- Fluid intelligence: Is impacted
- Significant intellectual changes in adults can negatively affect self-esteem, so it's important to address them
Cognitive Changes: Speed of Processing
- Decreases in speed of processing information within working memory
- Slowing in peripheral and central nervous systems and slowed sensory processing
- Leads to increased reaction time and increased time to process and retrieve new information
- Test scores can be influenced by test relevancy
- Older adults take time to understand and process information
- They may need longer appointments to ensure adequate time
Cognitive Changes: Executive Function
- Decreased planning, abstract thoughts, decision-making, cognitive flexibility, and appropriate behavior
- Speed and efficiency of problem solving are impacted
- Particularly in abstract reasoning
- Mental flexibility and set shifting in reasoning tasks is reduced
Intervention Strategies to Promote Learning and Occupational Engagement
-
Assist the client:
- Understand the mechanisms of memory and issues
- Develop strategies related to attention and working memory
- Use direct attention to what is to be learned
- Minimize distractions
- Increase attention especially for more than one modality/task
- Allow time for processing, reduce content presented, slow speech rate/pause, and increase exposure time
- Reduce stress and anxiety
- Allow self-pacing
- Encourage active verbalization (talk aloud) and elaboration of new information instead of just rehearsal
- Provide clear instructions for organizing a complex task - logically group information and focus on essential aspects
- Build on what the client already knows
- Encourage organizational strategies
- Use mnemonic/reminder strategies
- Cognitive training can reduce cognitive and functional decline
ACTIVE Study: Advanced Cognitive Training for Independent and Vital Elderly
- Potential benefits include:
- Improved mental health
- Enhanced social connections
- Stronger connection to culture
- Improved physical and behavioral health
- Reduced:
- Stress
- Isolation and loneliness
- Primary and secondary care use
Emotional Well-Being
- Positive emotions increase, and negative emotions decrease between 50 and 70 years
- Before and after those ages, patterns vary across specific emotions
- Older adults generally have a higher positive-to-negative emotional experience than younger adults
Emotion and Physiology - Stress
- Older adults have greater difficulties returning to homeostasis compared to young adults with high levels of sustained emotional arousal
- Stressful situations for older adults include:
- Social isolation
- Neurological dysfunction
- Chronic and unpredictable stressors
- Overload of predictable stressors
Depression
- The rate of depression in older adults is lower than in younger adults
- Symptoms of depression are more harmful in older adults:
- Decreased cognitive, physical, and social functioning
- Increased risk of morbidity (e.g., cardiac events), suicide, self-neglect, and mortality
- Depression can present as a lifetime illness or a late-life condition
- Older adults tend to present physical symptoms rather than emotional ones:
- Sleep problems
- Fatigue
- Psychomotor slowing
- Impaired cognition
- Loss of interest in living
- Hopelessness about the future
- The risk of depression in older adults is increased with sudden events in later life:
- Financial difficulties/socioeconomic disadvantages
- A new illness or disability/family member with a new illness or disability
- Retirement/change in living situation
Anxiety
- Characterized by feelings of worry, nervousness, or unease
- More common than depression in older adults, and a mixture of both is frequent
- Shared risk profiles with depression
- Often relates to fear of falling and/or is comorbid with other illnesses
- Reduced activity level
- Older adults may avoid engaging in activities due to anxiety
Occupational Therapy Role
-
Screening:
- Interview clients
- Use standardized tools (examples not provided)
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Description
Explore various cognitive training techniques including memory, reasoning, and processing speed training. This quiz covers strategies, exercises, and instructional methods designed to enhance cognitive abilities and problem-solving skills. Perfect for those interested in improving their mental performance.
