40 Questions
Which symptom of mild cognitive impairment involves the ability to remember to perform an action in the future?
Prospective memory
What aspect of cognition is more affected by aging than verbal cognition?
Visuospatial cognition
In MCI, what refers to the ability to access prior knowledge in long-term memory and integrate it with new text information?
Ability to remember new text information
Which symptom of MCI relates to struggling with interpreting an object in three dimensions, judging distances, or navigating stairs?
Visual depth perception
What does MCI refer to?
A set of symptoms
In MCI, what does the term 'working memory' refer to?
Holding and manipulating information in the mind
Which aspect of cognition involves the ability to remember personal events and experiences?
Episodic memory
In MCI, what is affected more by aging than verbal cognition?
Verbal and visuospatial working speed
What is the prevalence of mild cognitive impairment in those aged 80-89 years?
25%
Which tool is preferred for brain imaging in patients with mild cognitive impairment?
MRI
What is the abbreviation for the test used for rapid assessment of delirium?
4AT
Which age group is at higher risk for delirium?
>65 years
What is the acronym for the standard brief assessment to determine if a full dementia evaluation is needed?
sMMSE
What is the abbreviation for General Practitioner Assessment of Cognition?
GPCOG
What should be included in the overall assessment of a patient with mild cognitive impairment?
Evaluation of mental status and examination for comorbid conditions
Which type of patients may benefit from the approach to diagnosis and management outlined for delirium, even if they do not meet all the criteria for a diagnosis of delirium?
Patients with pre-existing cognitive impairment
What is the aim of making a diagnosis of dementia in the early stages?
To define clinical, biochemical, and structural presence of Alzheimer's disease
What is the purpose of the 6CIT - Kingshill version 2000?
Brief screening for early dementia
What does spiritual care involve?
Connecting or reconnecting individuals with things that are at the core of their being
What is the major contributor to an individual’s quality of life and sense of wellbeing?
Sexuality and intimacy
What is dementia characterized by?
Widespread impairment of mental function
What is the SLUMS used for?
Screening for early signs of Alzheimer’s and dementia
What is the significance of positive sexual relationships and behaviors in older adults?
They are integral to maintaining good health and general well-being
What are the proposed diagnostic criteria for dementia focused on?
Presence of abnormal biomarkers and episodic memory impairment
What does the mnemonic PINCHES ME stand for in the context of delirium assessment?
A mnemonic for reviewing possible causes for delirium
What is the usual onset and duration of delirium?
Onset over hours to days, lasting for days to weeks
What is the approximate incidence of delirium in nursing homes or post acute care settings?
60 percent
What is the most common cause of delirium in older people?
Pre-existing dementia
What does Advance Care Planning refer to?
Discussion and reflection about goals, values, and preferences for future treatment
How is 'spirituality' distinguished from 'religion'?
'Spirituality' is the personal search for meaning and purpose in life, while 'religion' refers to beliefs, practices, and traditions associated with religious groups.
What does Social Assessment suggest about socially-involved individuals?
They experience better health outcomes than socially isolated persons.
Why are older people particularly vulnerable to environmental factors?
Due to their increased time spent at home compared to other members of society
What is the major value of the HAM-A (Hamilton Anxiety Rating Scale)?
To document the results of pharmacotherapy or psychotherapy
Which scale is ideal for evaluating the clinical severity of depression and for monitoring treatment?
GDS-15
What does the GDS-4 (Geriatric Depression Scale) evaluate?
Screening for depressive symptoms in the elderly
According to DSM-IV criteria, what percentage change in weight constitutes a significant weight change?
5%
What represents a cultural shift requiring a more biologically focused workup than previous approaches?
The development of drugs directed at altering pathogenesis
What is the prevalence of depression in older people according to the text?
5-10%
What is the purpose of the PHQ-9 (Patient Health Questionnaire 9)?
To reach a tentative diagnosis of depression and assess its severity
What does the GAD-7 (Generalized Anxiety Disorder 7 Item Questionnaire) screen for?
Generalized anxiety disorder
Study Notes
Mild Cognitive Impairment (MCI)
- MCI refers to a condition where an individual experiences memory or cognitive problems that are more severe than those seen in normal aging but are not severe enough to interfere with daily living.
- In MCI, working memory refers to the ability to hold and process information in the mind for a short period.
Cognitive Functions
- Episodic memory involves the ability to remember personal events and experiences.
- Semantic memory is the ability to access prior knowledge in long-term memory and integrate it with new text information.
Spatial Ability and Visual-Spatial Ability
- Spatial ability in MCI is affected, making it difficult to interpret objects in three dimensions, judge distances, or navigate stairs.
Prevalence and Diagnosis
- The prevalence of MCI in those aged 80-89 years is high.
- The preferred tool for brain imaging in patients with MCI is MRI.
- The CAM (Confusion Assessment Method) is used for rapid assessment of delirium.
- The GP-COG (General Practitioner Assessment of Cognition) is a tool used to assess cognition.
Delirium
- Delirium is more common in those aged 80 and above.
- The SLUMS (Standardized Mini-Mental State Examination) is used to assess cognitive function.
- The 6CIT (Kingshill Version 2000) is a short cognitive assessment tool.
- The purpose of making a diagnosis of dementia in the early stages is to improve the quality of life and sense of wellbeing.
Dementia
- Dementia is characterized by a decline in cognitive function, such as memory loss, confusion, and difficulty with communication and problem-solving.
- The proposed diagnostic criteria for dementia focus on cognitive symptoms, such as memory impairment and difficulty with judgment and problem-solving.
Spirituality and Quality of Life
- Spiritual care involves providing emotional and psychological support to patients.
- Positive sexual relationships and behaviors are important for older adults' quality of life and sense of wellbeing.
Assessment and Diagnosis
- The aim of the overall assessment of a patient with MCI is to identify cognitive, functional, and behavioral symptoms.
- The CAM (Confusion Assessment Method) is used to assess delirium.
- The HAM-A (Hamilton Anxiety Rating Scale) is used to evaluate the clinical severity of anxiety and monitor treatment.
Depression and Anxiety
- The GDS-4 (Geriatric Depression Scale) evaluates depression in older adults.
- The PHQ-9 (Patient Health Questionnaire 9) assesses depression.
- The GAD-7 (Generalized Anxiety Disorder 7 Item Questionnaire) screens for anxiety.
Review the mnemonic 'PINCHES ME' for delirium causes, including pain, infection, nutrition, constipation, hydration, endocrine+electrolyte, stroke, medication, alcohol, and environmental factors. Learn about the onset and incidence of delirium in different demographics.
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