Aging and Cognitive Changes in Older Adults, Exams of Advanced Education

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OTD 423 Exam 1 with complete

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What ipercentage iof iolder iAmericans iare iover i65? i- iAnswers i-54.1% What ipercentage iof iolder iadults iin ithe iUS ihave iobtained ia ibachelor's idegree iof ihigher? i- iAnswers i-33% Who iis imore ilikely ito ibe imarried, iolder imen ior iolder iwomen? i- iAnswers i-men What iis ithe imajor isource iof iincome ifor iolder iadults? i- iAnswers i-social isecurity What iis ithe iprimary isource iof ihealth iinsurance ifor iolder iadults? i- iAnswers i-Medicare Who iare ithe ipoorest iolder iadults? i- iAnswers i-Hispanic iwomen iliving ialone What ipercentage iof iolder iadults iover i 65 iare istill iworking? i- iAnswers i-18% What inumber iof iolder iadults icurrently ilive iin iinstitutional isettings? i- iAnswers i-1. imillion What ipercentage iof iolder iadults iliving iin ithe icommunity iexperience iindependent iliving idifficulties? i- iAnswers i-19% Free iRadical iTheory i- iAnswers i-free iradical idescribes iany imolecule ithat ihas ia ifree ielectron iand ithis iproperty imakes iit ireact iwith ihealthy imolecules iin ia idestructive iway it iis iknown ithat idiet, ilifestyle, idrugs iand iradiation iare iall iaccelerators iof ifree iradical iproduction iin ithe ibody Aging iTheories i- iAnswers i-complex iand imulti-dimensional iframework ithat ihelps ius ibetter iunderstand iaging. Membrane iTheory i- iAnswers i-age irelated ichanges iof ithe icells iability ito itransfer ichemicals, iheath, iand ielectrical iprocesses ithat iimpair iit as iwe igrow iolder ithe icell imembrane ibecomes iless ilipid/more isolid iwhich iimpedes iits iefficiency ito iconduct inormal ifunction iand ithere iis itoxic iaccumulation Mitochondrial iDecline iTheory i- iAnswers i-enhancement iand iprotection ithrough inutrients iand iATP isupplements iof ithe imitochondria iis ian iessential ipart iof ipreventing iand islowing iaging

Cross-Linking iTheory i- iAnswers i-accumulation iof icross-linked iproteins idamages icells iand itissues islowing idown ithe ibody iprocesses ileading ito iaging Programmed iLongevity i- iAnswers i-considers iaging ito ibe ia iresult iof isequential iswitching ion iand ioff iof icertain igenes iwith iabsence ibeing idefined ias ithe itime iwhen iage-associated ideficits iare imanifested Endocrine iTheory i- iAnswers i-believes ithat ibiological iclock iacts ithrough ihormones ito icontrol ithe ipace iof iaging Immunological iTheory i- iAnswers i-states ithat ithe iimmune isystem iis iprogrammed ito idecline iover itime ileading ito ivulnerability ito iinfection, iaging, iand ideath Wear iand iTear iTheory i- iAnswers i-believe ivital iparts iin iour icells iand itissues iwear iout, iresulting iin iaging Rate iof iLiving iTheory i- iAnswers i-supports ithe itheory ithat ithe igreater ian iorganisms irate iof ioxygen ibasal imetabolism, ithe ishorter iits ilifespan Neuroendocrine iTheory i- iAnswers i-elaborates iwear iand itear iby ifocusing ion ineuroendocrine isystem this isystem iis ia icomplicated inetwork iof ibiochemicals ithat igovern ithe irelease iof ihormones iwhich iare ialtered iby ithe ihypothalamus as iwe igrow iolder ithe ihypothalamus iloses iits iprecision iregulatory iability iand ithe ireceptors iwhich iuptake ihormones ibecome iless isensitive Activity iTheory i- iAnswers i-emphasizes ithe iimportance iof iongoing isocial iactivity, isuggests ithat ia iperson's iself-concept iis irelated ito ithe iroles iheld iby ithat iperson Disengagement iTheory i- iAnswers i-first iformal itheory ithat iattempted ito iexplain ithe iprocess iof igrowing iolder refers ito iinevitable iprocess iin iwhich imany iof ithe irelationships ibetween ia iperson iand iother imembers iof isociety iare isevered iand ithose iremaining iare ialtered iin iquality Continuity iTheory i(psychosocial itheory) i- iAnswers i-person iadapts ito ilife ichanges iby iusing iinternal ior iexternal istrategies internal icontinuity i- iAnswers i-person ilinks inew iexperiences iwith imemories iof iolder iones external icontinuity i- iAnswers i-interacting iwith ifamiliar ipeople iin ifamiliar ienvironments Productive iAging i- iAnswers i-having ithe iphysical, iemotional, isocial iand ispiritual iresources icombined iwith iability ito iadapt ito ilife ichanges iin iorder ito iengage iin imeaningful iand iimportant iself-selected ioccupations ias ilife igoes ion

life ispan i- iAnswers i-looks iat ithe ibiological iand ienvironmental ifactors ithat iimpact iit life icourse i- iAnswers i-looks iat ipersons inarrative iand ihistorical ievents Ageism i- iAnswers i-stereotyping iand ihaving inegative ibias itoward iolder iadults Veterans/Traditionalists iGeneration ishaping ivalues i- iAnswers i-(1920-1945)

• moved ifrom ifarms ito icities
• Depression
• WW
• shaped iworld iwith ipost iwar ipolicies Silents/Traditionalists iGeneration ishaping ivalues i- iAnswers i-(1926-1943)
• immigrant iparents
• WW2, iKorean iWar
• Communist iscare i(cold iwar) Baby iBoomers iGeneration ishaping ivalues i- iAnswers i-(1946-1964)
• Vietnam iWar
• Watergate
• Woodstock
• financially isecure itime
• civil irights, isexual irevolution, ifeminism Generation iX ishaping ivalues i- iAnswers i-(1965-1980)
• higher idivorce irate
• Iran
• challenger ispace ishuttle iexplosion Generation iY/Millennials ishaping ivalues i- iAnswers i-(1981-200)
• 9/11, iterrorism
• Columbine, iAurora, iOklahoma iCity
• strong iparental iinfluence
• most iprotected igeneration Intergenerational ilearning iallows iolder iadults: i- iAnswers i-1. ibe imore iproductive

2. ilearn iabout inew iinnovations iand itechnology Intergeneration ilearning iallows iyouth ito idevelop: i- iAnswers i-1. iempowerment, ileadership, icitizenship
3. iimproved icommunication iskills
4. ipositive iattitudes itoward iaging Traditionalists iin iTherapy i- iAnswers i--respect ifor ihealth icare iteam

• hard iworker
• adherence ito iintervention iprogram i(maybe iextreme)

• value iformal icommunication iwith iintervention/education
• learning imotived iby ithe iconcept iof i"greater igood"
• straight iforward ipresentation, ieducational imaterials iin isummary iform
• value iin-person icommunication Baby iBoomers iin iTherapy i- iAnswers i--work ias ia iteam iin iintervention
• value iin-person icommunication
• works ihard
• wants ito ibe iinvolved iand ivalued
• wants ito ilearn, ivalues ilearning ifor ilearning isake Body icomposition ichanges iin iolder iadults: i- iAnswers i-decreased ibody iwater, idecreased itotal ilearn imass i(muscle), idecreased ibody ifat, idecreased ibone idensity Cardiovascular ichanges iin iolder iadults: i- iAnswers i-decreased icardiac ioutput, iincreased iperipheral iresistance Respiratory isystem ichanges iin iolder iadults: i- iAnswers i-decreased istrength iof imuscles ithat ifacilitate ilungs, idecreased imax ibreathing icapacity, idecreased igas iexchange Kidney ichanges iin iolder iadults: i- iAnswers i-decreased irenal iblood iflow, idecreased iglomerular ifiltration irate Liver ichanges iin iolder iadults: i- iAnswers i-decreased ihepatic iblood iflow, idecreased isize iof iliver CNS ichanges iin iolder iadults: i- iAnswers i-increased ipermeability iat iblood-brain ibarrier loss iof isubcutaneous ifat iaround ithe ieye i- iAnswers i-decreased inear ivision decreased itissue ielasticity iand itone i- iAnswers i-poor ieye icoordination decreased istrength iof ieye imuscles i- iAnswers i-distortion iof iimages decreased icorneal itransparency i- iAnswers i-blurred ivision degeneration iof ithe isclera, ipupil, iand iiris i- iAnswers i-compromised inight ivision increase iin idensity iand irigidity iof ilens i- iAnswers i-loss iof icolor isensitivity i(green, iblue, iviolet) increased ifrequency iof idisease iprocesses islowing iof iCNS iinformation iand iprocessing i- iAnswers i-difficulty iwith irecognition iof imoving iobjects, iitems iwith ia icomplex ifigure, ior iitems ithat iappear iin/out iof ilight iquickly

Macular idegeneration i- iAnswers i-central ipart iof iretina iwears idown iresulting iin iloss iof icentral ivision Glaucoma i- iAnswers i-damage ito ioptic inerve iusually ihappens iwhen ifluid ibuilds iup iin ithe ifront ipart iof ithe ieye iand iincreases ipressure iand idamages ioptic inerve i- itunnel ivision Cataracts i- iAnswers i-cloudy iarea iin ithe ilens iof ieye Diabetic iretinopathy i- iAnswers i-damage ito iblood ivessels iof ithe ilight isensitive itissue iin ithe iback iof ithe ieye i(retina) i- ivision ican ibe iblurred ior ihave idark ispots Arcus iSenilis i- iAnswers i-half icircle iof igrey, iwhite, ior iyellow ideposits iin ithe iouter iedge iof iyour icornea, ithe iclear iouter ilayer ion ithe ifront iof ieye imade iof ifat iand icholesterol ideposits pharmacokinetics i- iAnswers i-how ibody iaffects imedication i(ADME) pharmacodynamics i- iAnswers i-how imedication iaffects ithe ibody i(physiological iparameters) Polypharmacy i- iAnswers i-use iof imultiple imedications i(5 ior imore) Anticholinergic ieffects: i- iAnswers i-dry ieyes, idry imouth, iblurred ivision, ifatigue, idisorientation, iconstipation, iurinary iretention CNS ieffects: i- iAnswers i-confusion, isedation, idizziness, iagitation, iirritability, ihallucinations Gastrointestinal ieffects: i- iAnswers i-constipation, idiarrhea, imucosal idamage i(ulcerations, iGI ibleed) Drugs ithat icause imajor ifall irisks: i- iAnswers i-hypnotics anxiolytics narcotic ianalgesics muscle irelaxants eccentric iviewing i- iAnswers i-technique iused iby ipeople iwith icentral ivision iloss, imethod iby iwhich ithe iperson ilooks islightly iaway ifrom isubject ito iview iit iperipherally iwith ianother iarea iof ivisual ifield accommodation i- iAnswers i-ability iof ithe ieye ito ichange iits ifocus ifrom idistant ito inear iobjects, iprocess iachieved iby ithe ilens ichanging ishape contrast isensitivity i- iAnswers i-ability ito idistinguish iforeground ifrom ibackground, iability ito idistinguish ibetween ifiner iand ifiner iincrements ibetween ilight iand idark

presbyopia i- iAnswers i-difficulty iseeing inear iobjects levator ipalpebrae isuperioris iweakens i- iAnswers i-problems iwith iupward igaze iand iconvergence iresulting iin ipoor ieye icoordination iand idifficulty ifocusing cornea ithickens/flattens, iless ismooth iand imore irigid i- iAnswers i-causes ior iincreases iastigmatism iresulting iin iblurred ivision increased ipigments iin icornea i- iAnswers i-reduced icorneal itransparency imay ireduce ivisual ifield iand idecrease icorneal isensitivity pupil isize idecreases, ibecomes imore ifixed i- iAnswers i-senile imiosis, imay iaffect idepth iperception Iris iwith iaging i- iAnswers i-decreases iin idilation idue ito iincrease iin iconnective itissue, isclerosis iin iblood iand imuscle iloss leads ito igradual iloss iin ivision, igreater idifficulty iseeing iin ilow ilight Rod iwith iaging i- iAnswers i-density ican idecrease iup ito i30% iand iretina iloses ineurons leads ito inarrower ivisual ifield, idifficulty iseeing iin ilow ilight, iproblems iwith ilight/dark iadaption, iincreased isensitivity ito iglare Lens iwith iaging i- iAnswers i-elasticity idecreases iin ilens iso iit ihas ia idecreased iability ito ichange ishape iin iresponse ito idistance results iin idifficulty iseeing inear iobjects, idecreased ivisual iacuity presbycusis i- iAnswers i-degradation iof ihearing iwith iage conductive i- iAnswers i-blockage iof iinner iear sensorineural i- iAnswers i-damage ito icochlea, ibrainstem itract, inerve icells, icortex ior iall central iauditory iprocessing idisorder i- iAnswers i-deficit iin iability ito iinternally iprocess iand icomprehend isounds tinnitus i- iAnswers i-ringing iin iears anosmia i- iAnswers i-lack iof ismell hyposmia i- iAnswers i-decrease iin ismell dysosmia i- iAnswers i-distortion iof ismell ageusia i- iAnswers i-absence iof itaste

hypogeusia i- iAnswers i-decrease iin isensitivity ito itaste dysgesia i- iAnswers i-distortion iof itaste phantosmia i- iAnswers i-smell ihallucinations phantogeusia i- iAnswers i-taste ihallucinations Osteoporosis i- iAnswers i-decrease iin ibone imass, idisruption iin ibone iarchitecture, iand iincreased irisk iof ifracture osteoporosis irisk ifactors iyou iCANNOT ichange: i- iAnswers i--gender i

• age i
• body isize
• ethnicity
• family ihistory what iethnicity ihas igreater irisk iof iosteoporosis? i- iAnswers i-caucasian iand iasian iwomen osteoporosis irisk ifactors iyou iCAN ichange: i- iAnswers i--sex ihormones
• anorexia inervosa
• calcium iand ivitamin iD iintake
• medication iuse
• lifestyle
• cigarette ismoking
• alcohol iintake what imedications iincrease irisk ifor iosteoporosis? i- iAnswers i-longterm iuse iof iglucocorticoids iand isome ianticonvulsents Fear iof iFalling i- iAnswers i-a ilack iof iself-efficacy ithat ione ican iavoid ifalls iwhile idoing ieveryday iactivities, ia ilasting iconcern iabout ifalling ithat ican ilead ito iindividuals inot idoing iactivities ithat ithey iare icapable iof iperforming consequences iof iFOF: i- iAnswers i--stop iparticipating iin iactivities
• legs iweaken ifrom iinactivity
• inactivity ileads ito ifalls
• may imake ithe iperson ifeel ialone
• may icause idepression cycle iof iFOF: i- iAnswers i-1. ifall

2. igreater idependence iwith iADLs
3. isedentary ilifestyle
4. idecreased iphysical istrength iand ibalance, idecreased iactivity itolerance
5. irestricted isocial iand iactivity iparticipation, iincreased idebility

Functional iReach iTest i- iAnswers i-assesses idynamic ibalance <6in i= ilimitation iin ifunctional ibalance iand isignificant ifall irisk 6 - 10in i= imoderate ifall irisk 10in i= ihealthy iolder iadult 5x iSit ito iStand i- iAnswers i-quantify ifunctional ilower iextremity istrength iand/or iidentify imovement istrategies ia ipatient iuses ito icomplete itransitional imovement

13.6 isec i= iincreased idisability iand imorbidity TUG iTest i- iAnswers i-assess ia ipersons imobility iand irequires iboth istatic iand idynamic ibalance <10 isec i= ihealthy iolder iadult Berg iTest i- iAnswers i-assesses istatic ibalance iand ifall irisk, ifocuses ion ifunctional imobility ion inon-vestibular ibalance 0 i= ilowest ilevel iof ifunction, i 4 i= ihighest ilevel iof ifunction 41 - 56 i= iindependent 21 - 40 i= iwalking iwith iassistance 0 - 20 i= iwheelchair ibound FaB i- iAnswers i-identify ilevel iof iawareness iand ipractice ibehaviors ithat icould iprevent ifalls 1 i= inever, i 4 i= ialways i Highest iscores i= isafest ibehavior FROP-com i- iAnswers i-to ipredict ifalls ifor iolder iadults, ibased ion itheir irisk ifactors 0 i= ileast isevere, i 3 i= imost isevere 0 - 11 i= imild ifall irisk 12 - 18 i= imoderate ifall irisk 19 - 60 i= ihigh ifall irisk Sensory imemory i- iAnswers i-pre-attentive imemory isystem ithat istores iincoming iinfo ifor ia ivery ishort itime iand ieither iis iforgotten ior igoes iinto ishort iterm imemory Short-term imemory i- iAnswers i-immediate irecall iof iinformation iwithout irehearsal isuch ias ia ishort ilist iof i 5 - 7 iitems ito iget iat ithe istore Working imemory i- iAnswers i-when iwe istore, imaintain, iand imanipulate iinfo Long iterm imemory i- iAnswers i-remembering ievents iand iinformation ifrom iweeks ito imonths ito iyears episodic imemory i- iAnswers i-specific ito ithe iperson, ipersonal iexperiences, i"autobiographical ievents", iunderstanding iwhen, iwhere, iand ihow isomething ioccurred

explicit imemory i- iAnswers i-conscious imemory semantic imemory i- iAnswers i-"insight", iunderstanding iof iexternal iworld, imost idurable, iprocessing iof ifact, iidea, iand iconcepts implicit imemory i- iAnswers i-unconscious iprocessing procedural imemory i- iAnswers i-basic imemory iwhich iinvolves icognitive, iperceptual iand imovement, ihabits, iand iroutines ithat iare iimagined Mild icognitive iimpairment i- iAnswers i-intact iADLs ibut imore ieffort iand idifficulty amnestic iMCI i- iAnswers i-primarily iaffects imemory non-amnestic iMCI i- iAnswers i-affects ithinking iskills Cognitive iContinuum i- iAnswers i-preclinical MCI ileading ito iAD AD sustained/focused iattention i- iAnswers i-one itask iat ia itime selective iattention i- iAnswers i-direct iattention ito ione itask iand iignoring iothers alternating iattention i- iAnswers i-switch ibetween itwo ior imore itasks iat ia itime dividing iattention i- iAnswers i-pay iattention ito imore ithan ione ithing iat ia itime Lewy ibody idementia i- iAnswers i-Parkinson's ilike isymptoms, iprogressive Vascular idementia i- iAnswers i-not igradual ichanges, iemotions iand ienergy ichanges, icognitive ichanges symptoms imay ivary ibased ion ipart iof ibrain iaffected Frontotemporal idementia i- iAnswers i-frontal i- irude iand imean ibehavior, ipersonality ichanges temporal i- ilanguage iloss Alzheimer's idisease i- iAnswers i-a iprogressive ineurodegenerative idisease, icharacterized iby iloss iof ifunction iand ideath iof inerve icells iin iseveral iareas iof ithe ibrain no iknown icure most icommon iform iof idementia causes iof iAD: i- iAnswers i-age family ihistory genetics

Allen iCognitive ilevel i 1 i- iAnswers i-automatic iactions, iend istage iAD Allen iCognitive ilevel i 2 i- iAnswers i-postural iactions, ilate istage iAD

• repetitive iactions
• cues i- ishort, iclear idirections
• compensatory ienvironmental imods
• involve icaregivers Allen iCognitive ilevel i 3 i- iAnswers i-manual iactions, imiddle istage iAD
• safety iissues
• may ibe idisoriented ix3, igets ilost ieasily
• partially icompletes itasks
• tactile iactions
• does iwell iwith irepetitive itasks
• 30 imin iattention ispan Allen iCognitive ilevel i 4 i- iAnswers i-goal idirected iactions, imiddle istage iAD
• unsafe
• visual icues
• performs ione istep idirections
• repetitive itasks
• utilizes iprocedural imemory
• BADLs
• can iuse istrategies Allen iCognitive ilevel i 5 i- iAnswers i-exploratory iactions, imild icognitive iimpairment Allen iCognitive ilevel i 6 i- iAnswers i-"normal" iplanned iactions multicomponent iintervention i- iAnswers i-a iset iof iinterventions ioffered ithat iaddress imore ithan ione iintervention istrategy multifactorial iintervention i- iAnswers i-tailored isubset iof iinterventions ithat itarget iidentified irisk ifactors muscle istrength i- iAnswers i-main ideterminant iof imovement iand iperformance iin ialmost ievery iADL muscle ipower i- iAnswers i-more iinfluential ithan imuscle istrength iin iolder iadults imobility, iphysical ifunction, iand ifunctional iperformance St. iLouis iUniversity iMental iStatus i(SLUMS) i- iAnswers i-early iidentification iof icognitive ichanges ithat icould iindicate ionset iof iAD 18 - 65+ client iw/ ihigh ischool ieducation

• 27 - 30 i= inormal
• 21 - 26 i= imile ineurocognitive idisorder
• 0 - 20 i= iindicates idementia client iw/ iless ithan ihigh ischool ieducation
• 25 - 30 i= inormal
• 20 - 24 i= imild icognitve idisorder
• 1 - 19 i= iindicates idementia Short iOrientation iMemory iConcentration iTest i(Short iBlessed iTest) i- iAnswers i-quick itool ito ihelp idetermine iif iimpairments iare ipresent iin ithe iareas iof iconcentration, imemory, iand iorientation 0 - 4 i(normal) 5 - 9 i(questionable) 10+ i(impairment iconsistent iwith idementia) Allen iCognitive iLevel iScreen i(ACLS) i- iAnswers i-measure ifunctional icognition iso iclinicians ican iset iup iplan ifor iintervention ithat iwill icompensate ifor ilimitations scale ifrom ileast icomplex i(3) ito imost icomplex i(5.8)