Week 11- Cognitive Changes

Question 1

PART 1

Answer 1

PART 1

Question 2

What are the 6 cognitive domains?

Answer 2

• Complex Attention
• Social Cognition
• Learning/Memory
• Language
• Perceptual Motor Function
• Executive Function

Question 3

What are the (3) types of memory?

Answer 3

• Sensory Memory
• Short-term Memory (STM)
• Long-term Memory (LTM)

Question 4

Sensory Memory:

• What are the (3) subtypes?
• What is it?
• What part of the brain controls it?

Answer 4

• Iconic (visual), Echoic (auditory), Haptic (touch)
• Input from the 5 senses, can be ignored or perceived and transferred to STM in <1s.
• Initial input to SENSORY AREAS of brain, then processed by HIPPOCAMPUS.

Question 5

STM:

• Limited capacity with temporal recall, processed in __-__s.
• What part of the brain controls it?

Answer 5

• 10-15s

- Prefrontal Cortex

Question 6

LTM:

• What are the (3) subtypes? Explain each.
• What part of the brain controls each subtype?

Answer 6

Implicit (procedural):

• Subconscious influence of previously encountered information on subsequent performance.
• Cerebellum, putamen, caudate nucleus, motor cortex

Explicit (declarative) Semantic:

• Structured facts, meanings, concepts, and knowledge.
• Prefrontal cortex, temporal cortex

Explicit (declarative) Episodic:

• Autobiographical of events, contextual knowledge, and associated emotions.
• Hippocampus

Question 7

Which of the types of memories remain stable with age, and which have a gradual decline?

Answer 7

Stable

• Sensory Memory
• STM
• LTM Implicit (procedural)

Gradual Decline

• LTM Explicit (declarative) Semantic
• LTM Explicit (declarative) Episodic

Question 8

How is Delirium different from Dementia?

Answer 8

• Delirium typically has a rapid onset (hrs-days) and is a sign of an underlying condition in older adults.
• Delirium is short in duration and typically resolves once the underlying condition has been addressed.

-Dementia is more gradual in onset (weeks-months-years) and is not caused by a different condition.

Question 9

What are the (3) types of Delirium?

Answer 9

• Hyperactive
• Hypoactive
• Mixed

Question 10

What are some pathophysiology’s behind Delirium? (4)

Answer 10

• Brain structural changes
• NT disturbance in central cholinergic/adrenergic pathways
• elevated inflammatory cytokines
• multifactorial in older adults

Question 11

Delirium is associated with increase in what (4) things?

Answer 11

• Increased LOS
• Increased recovery times
• Increased institutionalized care
• Increased morbidity/mortality

Question 12

Delirium Prevention and Management:

• ___-___% of cases are preventable.
• Determine cause and remediate ASAP.
• What are some drugs linked to Delirium? (3)
• Cognitive orientation, early mobility, enabling adequate hearing and vision, promoting a normal sleep-wake cycle, and proper nutrition/hydration are all __________ interventions to treat Delirium.

Answer 12

• 30-40%
• psychoactive agents, narcotics, anticholinergics
• nonpharmacological

Question 13

“A clinical syndrome of cognitive and functional decline, usually of a chronic or progressive nature.”

Answer 13

Dementia

Question 14

Dementia is a global impairment impacting intellectual functioning, memory, and at least one of what (5) things?

Answer 14

1. ) Abstract thinking
2. ) Judgment and language
3. ) Identification of people and objects
4. ) Personality changes
5. ) Ability to use object appropriately

Question 15

What are the (4) main types of Dementia?

Answer 15

• Alzheimer’s Disease (AD)
• Vascular Dementia (VD)
• Dementia with Lewy Bodies (DLB)
• Frontotemporal Dementia (FTD)

Question 16

• SCI = _________ cognitive impairment
• MCI = ________ cognitive impairment
• What is the difference between amnestic and nonamnestic cognitive impairment?

Answer 16

• SCI = Subjective Cognitive Impairment
• MCI = Mild Cognitive Impairment
• Amnestic (memory is primary loss), Nonamnestic (other areas more affected than memory)

Question 17

Vascular Dementia:

• ___-___% of cases.
• What areas of the brain are affected?
• Associated with ____ Disease and is more often ________ onset.
• Is memory loss usually more or less severe than AD?
• Can occur in conjunction with AD, what is this called?

Answer 17

• 20-30%
• medial temporal atrophy, cortical and subcortical lesions
• CV Disease, abrupt
• Less severe
• mixed dementia

Question 18

Vascular Dementia S/Sx. (3)

Answer 18

• Impaired attention, planning
• Difficulties with complex activities
• Disorganized thought

Question 19

Dementia with Lewy Bodies:

• ___% of cases, accepted to be highly _________/________.
• What areas of the brain are affected?
• Key features includes complex visual _________, __________, _______ disturbances, autonomic symptoms, and fluctuating ________.
• Can occur in conjunction with AD, what is this called?

Answer 19

• 8%, highly misdiagnosed/underdiagnosed
• less severe medial temporal lobe atrophy than AD, limbic, brainstem, neocortex
• complex visual hallucinations, Parkinsonism, sleep disturbances, autonomic symptoms, and fluctuating cognition
• mixed dementia

Question 20

Frontotemporal Dementia:

• ___-___% of cases.
• What areas of the brain are affected?
• Is it more common in older or younger groups?
• Is memory intact in early stage?
• Significant changes in behavior/personality.
• _________/_________ are common.
• What are the (3) types of FTD?

Answer 20

• 3-10%
• frontal and temporal lobes (depend on type of FTD)
• younger
• Yes, memory intact early
• Disinhibition/impulsiveness
• Pick’s Disease, Progressive Supranuclear Palsy, Corticobasal Degeneration

Question 21

Alzheimer’s Disease:

• ___-___% of cases.
• What areas of the brain are affected?
• ______ loss of memory and function leading to total dependence on caregivers.
• Eventual inability to _______ friends/family.

Answer 21

• 50-60%
• gradual
• recognize friends/family

Question 22

Neurobiological Changes of Cognitive Dysfunction:

• _________ changes occur years before symptoms appear in AD and other Dementias.
• In the asymptomatic to mild cognitive impairment stages, what is the most prominent change?

Answer 22

• neurobiological

- amyloid markers

Question 23

Amyloid beta is present throughout the lifespan in humans and found in all vertebrae. What are some beneficial roles of amyloid beta? (5)

Answer 23

• Antimicrobial activity
• Tumor suppression
• Sealing leaks in the BBB
• Promoting recovery from brain injury
• Regulating synaptic function

Question 24

What appears to be the driving force behind AD?

Answer 24

Amyloid beta