Chpt 15 – Aging and Cognitive Disorders

I. Geropsychology

A. Study of normal aging, as well as of aging and psychological disorders

B. Disorders related to aging vs. how aging affects disorders

II. How do we know if something is age-related?

A. Age effects

B. Cohort effects

C. Time-of-measurement effects

D. Longitudinal vs. cross-sectional studies

III. Delirium

A. Change in sensorium (consciousness) that usually occurs suddenly

B. May look drunk, psychotic, but may also have periods of lucidity

C. Is usually reversible, by treating cause

D. Often in response to infection/surgery/meds, etc, esp in older adults

E. V. important to distinguish from dementia

IV. Dementia

A. Most common (but not ONLY) is Alzheimer’s

B. Is gradual deterioration, and is usually irreversible

C. Memory problems are primary sx

1. other areas (e.g. social functioning, executive functioning, recognition/naming) also affected.

D. Only diagnosed definitively on autopsy

E. Treatment/Management

1. If possible, treat medical cause (v. unusual)

2. Some meds appear to slow deterioration

3. Assistance with daily functioning (ex: larger objects, footprints on floor, labels, other memory aids, etc).

4. Residential or other 24-hour care

4. Support for caregivers

V. “Pseudodementia”

A. Depression in older adults often mislabeled as dementia

B. How to distinguish between “pseudodementia” & dementia?

1. Willingness to try but makes mistakes vs. “I don’t know”

2. Lack of memory deficits

3. Change in functioning with proper motivation

VI. Other disorders, and general issues

A. Differences in presentation of many disorders in older adults

1. e.g., focus of worries in anxiety, which substances are more likely to be abused in substance abuse, etc

B. Importance of looking at realistic factors, such as

1. e.g., increased losses for depression, increased victimization for anxiety/paranoia, sensory deficits for paranoia…

C. Importance of not attributing too much to aging (e.g., avoiding ageism)

D. Importance of treatment