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What are key signs for depression in the elderly?
- -Common in older adults
- -High Suicide rates
- -Hallmark sign of somatic complaints and feelings of worthlessness and loneliness
- -ECT works well in this population
- -Suspciousness and delusions
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What are basics of cognitive disorders?
- -NOT part of aging
- -Fundamental abilities of memory and learning are lost
- -Disorientation, confusion, loss of abstract thinking and inability to complete ADLs
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What are the nondementia cognitive disorders?
- -Mild Cognitive Impairment (MCI): not interferring with functioning ability
- -Delirium
- -Pseudodementia
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What is the most prevalent type of dementia?
-Alzheimer's disease
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What is delirium?
- -Rapid onset
- -Immediate medical intervention
- -Most often caused by general medical condition
- -Fluctuating level of consciousness, illusions
- -Must treat the underlying problem
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What are key signs of dementia?
- -Pronounced memory and cognitive disturbances
- -Gradual onset
- -Must rule out all phsycial disorders prior to a diagnosis of dementia
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What is Alzheimer's?
- -Incapable of retrieving the past and unable to contemplate the future
- -Usually (not always) has tangles and plaques
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What are key points to know about Alzheimer's?
- -Decreased ACh
- -Hippocampus and amygdala are signifcantly affected
- -Brain atrophy
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What are common signs of mild Alzheimer's?
-Mild: Word and name finding difficulties, getting lost, and difficulty performing usual activites
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What are common signs of Moderate Alzheimer's?
Moderate: Wandering, Apraxia, agnoisa, aphasia, assistance needed with ADLs
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What are common signs of severe Alzheimer's?
- -Gait disturbances
- -Unable to feed self
- -Double incontinence
- -Bed bound, death is coming
- -Total memory loss
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What is apraxia?
-inability to perform taks even with understanding and ability to move
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What is agnosia?
The loss of ability to recognize familiar objects
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What is aphasia?
-impairment of language ability
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What are nursing interventions?
- -Focus on present
- -Provide structure, change can cause distress
- -Take to bathroom on regular schedule
- -Develop strategies for wandering
- -Encourage the use of memory aids
- -Offer small foods
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How do antidementia drugs work?
- -Inhibit cholinesterase
- -approved for mild to moderate AD
- -Used to treat AD, not prevent the disease or slow its progression
- -May help maintain cognitive function
- -GI most common
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How does Memantine (Namenda) work?
- -Approved for moderate to severe AD
- -Can slow or prevent neuronal degeneration
- -Blocks NDMA receptors
- -Co prescribed with Donepezil (Aricept)
- -Few side effects or drug interactions
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What are the differences between dementia and depression?
- -Dementia: Affecct shallow, personality change, confabulation, no fluctuation, prgressive over months or years, primary
- Depression: personality unchanged, doesnt care or know, acute, secondary to clinical disorders
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