Geropsychology
A subdiscipline of psychology that addresses issues of aging, including normal development, individual differences, and psychological problems unique to older persons.
Do training programs in psychology do not provide sufficient education and experience in geropsychology?
Nope
Is depression and anxiety a natural consequence of growing old?
Nope
What are the most common psychological problems?
Depression and anxiety
Executive dysfunction
Difficulty planning, thinking abstractly, initiating and inhibiting actions.
Vascular depression
A mood disorder that occurs in the context of cerebrovascular disease
After what age do few older adults develop mania or bipolar?
65 years old
Which diseases is is more common with depression?
Vascular, neurological, or other physical diseases
When is depression diagnosed?
After a medical condition is diagnosed
Life-span developmental diathesis-stress model
Reviews influence of biological, stressful life events, and personal protective factors associated with depression.
Treatment of Depression in Older Patients
- Begin with a physical evaluation
- 60% improve once on medication
- Electroconvulsive therapy (ECT)
- Lithium in one-half to two-thirds of dosage for younger patients
- Cognitive-behavioral therapy
- Reminiscence Therapy
Which races is GAD most frequent in?
Puerto Rican and African American women
Treatment of Anxiety in Older Patients
- Rule out physical illnesses
- Benzodiazepines are the most frequently prescribed (e.g., 43%)
- Antidepressants
- CBT
- Psychosocial treatments (preferred)
Most common problems of Substance Related Disorders
- Overuse of alcohol
- Misuse of prescription medications
- Tobacco use
Alcohol abuse is LESS associated in older folks with:
-Antisocial behavior
-Legal problems
-Unemployment
-Lower socioeconomic status
Which gender does late onset alcohol abuse occur more often in?
Women
Which ethnicity is more likely to abuse substances?
There's no differences in ethnicities
Treatment of Substance-Related Disorders
- Brief alcohol counseling (BAC)
- Behavioral self-control procedures
- Medications for alcohol abuse (naltrexone and disulfiram, as well as antidepressants)
- Medications for benzodiazepines abuse (gradual discontinuation)
- Smoking cessation (brief inte
Late-onset schizophrenia
Schizophrenia that first appears after age 40
Very-late-onset schizophrenia
A schizophrenic-like-disorder, but with symptoms that do not include deterioration in social and personal functioning
Brain Abnormalities: Etiology of Schizophrenia and Psychosis
Enlarged ventricles, increased density of dopamine receptors, and reduced size of the superior temporal gyrus.
Other Causes: Etiology of Schizophrenia and Psychosis
Hormonal changes, psychosocial stressors, and deficits with hearing and vision.
Medical Conditions:
Stroke, tumor, Alzheimer's disease
Treatment of Psychosis
- Typical and atypical antipsychotic medications
- Skills training
- Family support
- Cognitive-behavioral therapy
- Psychoeducation
- Coping skills training
- Behavioral management
Delirium
- Alteration in consciousness that typically occurs in the context of a medical illness or after ingesting a substance
Etiology of Delirium
- Caused by serious systemic medical illness (AIDS, congestive heart failure, infection, or toxic effects of medication)
- Metabolic disorders (hypothyroidism or hypoglycemia)
- Neurological disorders (head trauma, stroke, seizure, or meningitis)
- Other
Treatment of Delirium
- First step is screening for known risks
- Support for family and patient
- Medication (antipsychotic and benzodiazepines)
- Education and supportive care
- Beneficial environmental manipulations
Types of Mild or Major Neurocognitive Disorder
- Major or mild neurocognitive disorder due to Alzheimer's disease
- Major or mild vascular neurocognitive disorder
- Substance/medication-induced major or mild neurocognitive disorder
Which disease is the most common type of neurocognitive disorder, accounting for as many as 75% of all cases?
Alzeimer's Disease
Cerebral senile plaques
Sphere-shaped deposits of a small molecule known as the beta-amyloid protein that form in the spaces between cells in the hippocampus, cerebral cortex, and certain other brain regions and blood vessels
Neurofibrillary tangles
Twisted protein fibers found within the cells of the hippocampus
The presence of the genetic allele (APOE) is in what ethnicities?
Anglos and Japanese patients
Amnestic MCI
Mild cognitive impairment in which cognitive complaints focus on memory difficulties
Treatment of Neurocognitive Disorder and Related Difficulties
- Cannot be reversed or cured
- Targets delaying disease progression
- Providing support and assistance to caregivers
- Changing the environment
- Medication (cholinesterase inhibitors CEIs and Aricept, memantine or Namenda)
- High doses of vitamin E
- An
The clinical presentation of major or mild vascular neurocognitive disorder differs from Alzheimer's disease in that it has
A sudden onset, more focal cognitive deficits, and a more stepwise progression of cognitive difficulties.
Brain abnormalities associated with Alzheimer's disease include
Excessive amounts of neurofibrillary tangles and plaques.
Which subtype of dementia accounts for approximately 75% of all patients diagnosed with the disorder?
Major or Mild neurocognitive disorder due to Alzheimer's Disease
Although there are many biological and environmental causes for delirium, the two primary causes are
serious systemic medical illness and medication toxicity.
In what way may hormonal factors influence the late onset of schizophrenia in women?
Estrogen may prevent psychotic symptoms before menopause.
Psychotic symptoms that occur with Alzheimer's disease is differentiated from those associated with late-life schizophrenia by the presence of...
simple, concrete delusions and visual hallucinations.
When the onset of substance abuse occurs later in life, researchers most often find
a history of habitual use and/or risky drinking.
Lily is a 71 year-old woman who recently suffered a minor stroke with no permanent physical or cognitive impairments. Within a week after the stroke, Lily who is normally an outgoing and energetic person, started to withdraw from family and friends and lo
vascular depression.
Medical problems are more common as people age. What issue does this raise for physicians and therapists who care for aging patients?
Many medical diseases and treatments create symptoms that mimic psychological disorders.
Although there is not yet a consistent definition of the term "successful aging," researchers have identified several common themes, including...
absence of cognitive impairments, perceived good health and an active lifestyle, and positive social relationships.