Dementia

1. Dementia Psychology 2617

2. Introduction • We are all getting older…. • Baby boomers are getting really old • (basically my parents’ generation) • So, we are starting to take notice of cognitive and neural declines with aging • Big big political thing too

3. Normal Aging • Older people are usually happier than us! • They get fewer small ailment • But more big ones • Many big adjustments though

4. Cognitive changes • Seems that there are cognitive changes, though how, why and to what extent, that is controversial • Crystallized vs fluid intelligence • Biggest changes are in new learning, abstract problem solving and behavioural speed

5. Brain changes • Brain does not age uniformly • Parietal lobe for example remains pretty much intact • Biggest decline is in the prefrontal cortex, where we think executive functioning is, explains the drop off in problem solving • Neurotransmitter changes and Parkinson’s

6. Dimentia • Multi infarct dimentia is probably the biggest cause of dimentia • Cortical vs subcortical dimentia • Static vs progressive • Reversible vs irreversible

7. Alzheimer’s • More than half of all dimentia is from AD • 2 times more women than men • Could be because women live longer though • Dimentia and brain stuff • Neurofibrillary tangles and neuritic plaques

8. AD • MASSIVE cell death • In essence, you get like lesions everywhere • ‘cortical’ dimentia, but you get these lesions, holes really, everywhere

9. Neurotransmitters affected • ACh is important in memory, especially in HP • The ACh system is severely damaged in AD • Indeed it is almost targeted • Other systems too though

10. Memory effects • Episodic effects • Eventually semantic effects • Retrieval cues don’t help • Information was not even encoded • Nondeclarative stuff, skills etc, are the last to go

11. Treatment • Most drugs target the cholinergic system • This disease not only affects the victim, but also his/her family • NGF is promising • Treatments will come, but, reversal, I dunno • Respite care is key for the family

12. Parkinson’s • And the depression continues • Does not always lead to dimentia, but it certainly can • Basically massive cell death in the substantia negra • This connects to the premotor cortex, controls fluidity of movement

13. symptoms • Starts out looking like normal aging • Aches and pains • Weakness • Depression • Unsteadyness • Eventually you get tremors

14. Symptoms continued • Bardykinesia • Masked facies • Festinating gait • Micrographia • Hypokinesia • Resting tremor • rigidity

15. Non motor symptoms • Visuo spatial impairments • Executive functioning impairments • Few linguistic issues beyond motor aspects of speech • Some memory impairment • Mood problems

16. Treatment • L Dopa is the ey • Basically maes more DA available • Can have powerful effects • MAOI as well

17. Huntington’s • Exceedingly rare • Dominant gene • Puppet lie movement • Psychotic like symptoms • Caudate nucleus dysfunction • Initiating movement, modulating it • Chorea • No cure

18. Creutzfeldt-Jakob • Anybody want a burger? • Also from just a random mutation • Spongiform disorders • Kuru or laughing disease

19. symptoms • Rapid deterioration of virtually everything • Happens in like 4 months • No cure • No treatment • No fun

20. Conclusions • Our best bet is probably genetic work • Gene therapy • Genetic counseling • Far as mad cow goes…..