NURSE-UN 1243 Adult and Elder Nursing 3 WEEK 2 Exam 1– Neuro Basics &the 3Ds
Changes in the Aging Brain
• Changes can occur, especially to the prefrontal cortex and the hippocampus
• Changes also occur in neurons, neurotransmitters and blood vessels
• Damage from free radicals and...
Changes in the Aging Brain
• Changes can occur, especially to the prefrontal cortex and the
hippocampus
• Changes also occur in neurons, neurotransmitters and blood vessels
• Damage from free radicals and inflammation increases
• Memory loss is NOT a normal part of the aging process.
• Growing evidence of the older brain having adaptive capacities
When/How to Assess Cognitive Function
When to assess:
• On admission/transfer/discharge
• Once a shift during hospitalization
• As a follow up to hospitalization within 6 weeks
• Before making an important healthcare decision
• Following changes in pharmacotherapy
• During a change in behaviour
How to assess:
• Mini mental status exam
• Mini COG
o Give patient 3 words
o Have them draw a clock w/ numbers & times
o Ask patient to repeat 3 words
,Dementia
• Chronic & terminal illness
• You have a change in mental ability enough to interfere w/ daily
functioning
• Must have memory loss AND another cognitive decline
o Loss of coherent speech, ability to understand spoken or written
language
o Loss of ability to recognize or identify objects
o Loss of ability to execute motor activities
o Loss of ability to think abstractly, make sound judgments, plan
& carry out complex tasks
Categories of dementia
• Dementia itself is not a diagnosis it is an umbrella term
o Alzheimer’s disease: amyloid plaques develop between nerve cells.
60% of
dementia diagnoses = Alzheimer’s.
o Lewy body disease: deposits of protein alpha-synuclein in the brain
o Vascular dementia: caused by damage due to major stroke or
multiple minor stroke
o Frontotemporal: progressive nerve cell loss in the frontal lobes
o Normal pressure hydrocephalus: accumulation of CSF
Mild Cognitive Impairment
• Often a prodromal stage of dementia
• Independent in ADLs but with a decrease in performance
• MCI + depression = much higher likelihood of developing Alzheimer’s
disease
Alzheimer’s Disease
• MOST expensive condition in the nation
• Risk factors include: age, family history, head trauma, diabetes,
depression, higher education, large social networks
• Pathophysiology: development of plaques between neurons loss of
connection and death of neurons
Warning Signs of Alzheimer’s
• Memory loss that disrupts daily life
• Challenges in problem solving
• Difficulty completing familiar tasks
• Confusion with time or place
• Trouble understanding visual images
• New problems w/ words
• Misplacing things
• Decreased/poor judgement
• Social withdrawal
• Changes in mood/personality
• Inability to manage a budget
, Behavioural Symptoms
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