Belangrijkste uit de colleges gerontology

Tip: bekijk van alle diseases die hier besproken worden ook in de DSM V, op deze manier weet je welke symptomen erbij horen en wanneer het gediagnosticeerd mag worden als welke disorder. 

Week 1

Summary:

• Proportion of older people is on the increase. 

• Older people can compensate for and adopt the aging related changes (including chronic diseases) for a long time. 

• Biology aging: result of the interaction between genetic and environmental influences.

• Aging is accompanied by a lot of physical changes: skin and hair, musculoskeletal system and cardiovascular system.

• To provide good health care several important factors need to be taken into account: quality of life, activities of daily living and instrumental activities of daily living. 

Week 2

Summary→ Both white and grey matter show decline in aging:

• Which is the most prominent in advanced aging­ 

• Anterior-posterior gradient

• Brain occupies progressively less space in brain cavity

Age-related cognitive decline may be best understood in terms of a range of mechanisms, including: ­ 

• speed deficit 

• ­vision and hearing deficit ­

• working memory deficit ­ 

• inhibition deficit

Model that combines all: Scaffolding Theory of Aging and Cognition (STAC).

Normal aging is accompanied by structural decline of the brain (grey matter , white matter, neurotransmitter receptors and transporters). Most cognitive functions show a steadily age-related decline.

Week 3

Summary→ The clinical manifestation is heterogeneous. Many patients have a mixed pathology and then vascular dementia and Alzheimer's disease are both present. 

Most common dementia in individuals < 65 years of age. Behavioral variant is most common but up to 40% of patients develop the language variant of frontotemporal dementia. Often misdiagnosed as a neuropsychiatric disorder or Alzheimer’s 

Week 5

Summary→ Progressive, hereditary disease with an insidious onset (CAG repeat on chromosome 4). Characterized by a degeneration of the striatum and a dysfunction of the fronto-striatal circuits. Characterized by motor symptoms (Chorea, hypokinesia, etc.), cognitive symptoms (Impairments in executive functions, attention, psychomotor speed, etc) and neuropsychiatric symptoms ( Depression, agitation, compulsive behaviour, etc). 

Week 6

Zie de lecture slides 35 en 26 voor een samenvatting van de features per disorder besproken in dit vak!

Summary→ Most caregivers take care of their parents, this is irrespective of the type of disease. Patients with dementia and cancer need more help with activities of daily living than patients with diabetes. Patients with dementia, cancer and diabetes all need support with instrumental activities of daily living.

The entire concept is based on negative as well as positive experiences related to caregiving. Can change throughout the patient’s illness, it constantly changes. 

Week 7

Kahoot acknowledgements: worldwide dementia is diagnosed every 3 seconds. The most common cause of dementia is Azlheimers disease. Dementia is not an intellectual disability. Intellectual disability is an IQ below 70. In diagnosing dementia clinical judgment doctor and psychologists are decisive. Diagnosis of dementia in intellectual disabled is mainly excluding other causes of decline. 75% of people with down syndrome develop dementia. This cause is the gene for Alzheimer-protein on chromosome 21. From 40 years onwards you can see this in their brain.

Summary→ High risk of Alzheimer's disease dementia for people with Down syndrome (APP overexpression Increased life expectancy). Difference between dementia, ID and other causes of symptoms, diagnostic procedure: 

- Baseline assessment is crucial to establish any change later in life

 - Differential diagnostics (excluding other causes) 

Scales used in the general population are not suitable for ID. Development of new behavioral scale BPSD-DS (Increase in anxious + apathetic behavior appears early).