Submitted by: Qurat ul ain Javed

Sap ID: 47031

Submitted to: Mam Zarrin Atif
Subject: Developmental psychology
Semester: 3rd
Program: BS Applied Psychology
Department: Riphah Institute of BS Clinical and Professional
Psychology
Assignment
Topic
Dementia, Alzheimers disease and Geriatric issues
 Dementia
Dementia is a term for several diseases that affect memory, thinking, and the ability to perform
daily activities. Alzheimer's is the most common cause of dementia.

The illness gets worse over time. It mainly affects older people but not all people will get it as
they age.

Things that increase the risk of developing dementia include:

 age (more common in those 65 or older)

 high blood pressure (hypertension)
 high blood sugar (diabetes)
 being overweight or obese
 smoking
 drinking too much alcohol
 being physically inactive
 being socially isolated
 depression.

Dementia is a syndrome that can be caused by several diseases which over time destroy nerve
cells and damage the brain, typically leading to deterioration in cognitive function (i.e. the ability
to process thought) beyond what might be expected from the usual consequences of biological
aging. While consciousness is not affected, the impairment in cognitive function is commonly
accompanied, and occasionally preceded, by changes in mood, emotional control, behavior, or
motivation.

Dementia has physical, psychological, social, and economic impacts, not only for people living
with dementia but also for their carers, families, and society at large. There is often a lack of
awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis
Causes
Dementia is caused by a variety of diseases that cause damage to brain cells. This damage
interferes with the ability of brain cells to communicate with each other. When brain cells cannot
communicate normally, thinking, behavior and feelings can be affected.

The brain has many distinct regions, each of which is responsible for different functions (for
example, memory, judgment and movement). When cells in a particular region are damaged, that
region cannot carry out its functions normally.

Different types of dementia are associated with particular types of brain cell damage in particular
regions of the brain. For example, in Alzheimer's disease, high levels of certain proteins inside
and outside brain cells make it hard for brain cells to stay healthy and to communicate with each
other. The brain region called the hippocampus is the center of learning and memory in the brain,
and the brain cells in this region are often the first to be damaged. That's why memory loss is
often one of the earliest symptoms of Alzheimer's.
Signs and symptoms

Changes in mood and behavior sometimes happen even before memory problems occur.
Symptoms get worse over time. Eventually, most people with dementia will need others to help
with daily activities.

Early signs and symptoms are:

 forgetting things or recent events

 losing or misplacing things
 getting lost when walking or driving
 being confused, even in familiar places
 losing track of time
 difficulties solving problems or making decisions
 problems following conversations or trouble finding words
 difficulties performing familiar tasks
 misjudging distances to objects visually.

Common changes in mood and behaviour include:

 feeling anxious, sad, or angry about memory loss

 personality changes
 inappropriate behaviour
 withdrawal from work or social activities
 being less interested in other people’s emotions.

Dementia affects each person in a different way, depending upon the underlying causes, other
health conditions and the person’s cognitive functioning before becoming ill.

Common forms of dementia

Dementia is caused by many different diseases or injuries that directly and indirectly damage the
brain. Alzheimer disease is the most common form and may contribute to 60–70% of cases.
Other forms include vascular dementia, dementia with Lewy bodies (abnormal deposits of
protein inside nerve cells), and a group of diseases that contribute to frontotemporal dementia
(degeneration of the frontal lobe of the brain). Dementia may also develop after a stroke or in the
context of certain infections such as HIV, as a result of harmful use of alcohol, repetitive
physical injuries to the brain (known as chronic traumatic encephalopathy) or nutritional
deficiencies. The boundaries between different forms of dementia are indistinct and mixed forms
often co-exist.

Treatment and care: There is no cure for dementia, but a lot can be done to support both
people living with the illness and those who care for them.
People with dementia can take steps to maintain their quality of life and promote their well-being
by:

 being physically active

 taking part in activities and social interactions that stimulate the brain and maintain daily
function.

In addition, some medications can help manage dementia symptoms:

 Cholinesterase inhibitors like donepezil are used to treat Alzheimer's disease.

 NMDA receptor antagonists like memantine are used for severe Alzheimer's disease and
vascular dementia.
 Medicines to control blood pressure and cholesterol can prevent additional damage to the
brain due to vascular dementia.
 Selective serotonin reuptake inhibitors (SSRIs) can help with severe symptoms of
depression in people living with dementia if lifestyle and social changes don’t work, but
these should not be the first option.

Alzheimer’s Disease

Alzheimer's is a type of dementia that affects memory, thinking and behavior. Symptoms
eventually grow severe enough to interfere with daily tasks.Alzheimer's disease is a brain
disorder that gets worse over time. It's characterized by changes in the brain that lead to deposits
of certain proteins. Alzheimer's disease causes the brain to shrink and brain cells to eventually
die. Alzheimer's disease is the most common cause of dementia — a gradual decline in memory,
thinking, behavior and social skills. These changes affect a person's ability to function.

Understanding Alzheimer's and dementia

Alzheimer's is the most common cause of dementia, a general term for memory loss and other
cognitive abilities serious enough to interfere with daily life. Alzheimer's disease accounts for
60-80% of dementia cases. Alzheimer's is not a normal part of aging. The greatest known risk
factor is increasing age, and the majority of people with Alzheimer's are 65 and older.
Alzheimer’s disease is considered to be younger-onset Alzheimer’s if it affects a person under
65. Younger-onset can also be referred to as early-onset Alzheimer’s. People with younger-onset
Alzheimer’s can be in the early, middle or late stage of the disease.
Symptoms:Memory loss is the key symptom of Alzheimer's disease. Early signs include
difficulty remembering recent events or conversations. But memory gets worse and other
symptoms develop as the disease progresses.At first, someone with the disease may be aware of
having trouble remembering things and thinking clearly. As symptoms get worse, a family
member or friend may be more likely to notice the issues.

Brain changes associated with Alzheimer's disease lead to growing trouble with;

Memory

Everyone has memory lapses at times, but the memory loss associated with Alzheimer's disease
persists and gets worse. Over time, memory loss affects the ability to function at work or at
home.

People with Alzheimer's disease may:

 Repeat statements and questions over and over.

 Forget conversations, appointments or events.
 Misplace items, often putting them in places that don't make sense.
 Get lost in places they used to know well.
 Eventually forget the names of family members and everyday objects.
 Have trouble finding the right words for objects, expressing thoughts or taking part in
conversations.

Thinking and reasoning :Alzheimer's disease causes difficulty concentrating and thinking,
especially about abstract concepts such as numbers.Doing more than one task at once is
especially difficult. It may be challenging to manage finances, balance checkbooks and pay bills
on time. Eventually, a person with Alzheimer's disease may be unable to recognize and deal with
numbers.

Making judgments and decisions :Alzheimer's disease causes a decline in the ability to
make sensible decisions and judgments in everyday situations. For example, a person may make
poor choices in social settings or wear clothes for the wrong type of weather. It may become
harder for someone to respond to everyday problems. For example, the person may not know
how to handle food burning on the stove or decisions when driving.

Planning and performing familiar tasks :Routine activities that require completing
steps in order become a struggle. This may include planning and cooking a meal or playing a
favorite game. Eventually, people with advanced Alzheimer's disease forget how to do basic
tasks such as dressing and bathing.

Changes in personality and behavior

Brain changes that occur in Alzheimer's disease can affect moods and behaviors. Problems may
include the following:

 Depression.
 Loss of interest in activities.
 Social withdrawal.
 Mood swings.
 Distrust in others.
 Anger or aggression.
 Changes in sleeping habits.
 Wandering.
 Loss of inhibitions.
 Delusions, such as believing something has been stolen.
Healthy brain and brain with Alzheimer's disease

 In the brain of someone with Alzheimer's disease, amyloid plaques form and tau proteins
change shape and become tangles.

Causes :The exact causes of Alzheimer's disease aren't fully understood. But at a basic level,
brain proteins fail to function as usual. This disrupts the work of brain cells, also called neurons,
and triggers a series of events. The neurons become damaged and lose connections to each other.
They eventually die.Scientists believe that for most people, Alzheimer's disease is caused by a
combination of genetic, lifestyle and environmental factors that affect the brain over time. In less
than 1% of cases, Alzheimer's is caused by specific genetic changes that almost guarantee a
person will develop the disease. In these cases, the disease usually begins in middle age.

The development of the disease begins years before the first symptoms. The damage most often
starts in the region of the brain that controls memory. The loss of neurons spreads in a somewhat
predictable pattern to other regions of the brain. By the late stage of the disease, the brain has
shrunk significantly.
Researchers trying to understand the cause of Alzheimer's disease are focused on the role of two
proteins:

 Plaques. Beta-amyloid is a fragment of a larger protein. When these fragments clump

together, they appear to have a toxic effect on neurons and to disrupt communication
between brain cells. These clumps form larger deposits called amyloid plaques, which also
include other cellular debris.

Tangles. Tau proteins play a part in a brain cell's

internal support and transport system to carry
nutrients and other essential materials. In
Alzheimer's disease, tau proteins change shape and
organize into structures called neurofibrillary
tangles. The tangles disrupt the transport system and
cause damage to cells.

Risk factors

Age :Increasing age is the greatest known risk factor for Alzheimer's disease. Alzheimer's isn't a
part of typical aging. But as you grow older, the chances of developing it increases.

One study found that every year there were four new diagnoses per 1,000 people ages 65 to 74.
Among people ages 75 to 84, there were 32 new diagnoses per 1,000 people. For those 85 and
older, there were 76 new diagnoses per 1,000 people.

Family history and genetics: The risk of developing Alzheimer's is somewhat higher if a
first-degree relative — your parent or sibling — has the disease. Just how genes among families
affect the risk is largely unexplained, and the genetic factors are likely complex.

A better-understood genetic factor is a form of the apolipoprotein E (APOE) gene. A form of the
gene, APOE e4, increases the risk of Alzheimer's disease. About 25% to 30% of the population
carries APOE e4. But not everyone with this form of the gene develops the disease.Scientists
have found rare changes in three genes that virtually guarantee a person who inherits one of them
will develop Alzheimer's. But these changes account for less than 1% of people with Alzheimer's
disease.

Down syndrome :Many people with Down syndrome develop Alzheimer's disease. This is
likely related to having three copies of chromosome 21. Chromosome 21 is the gene involved in
the production of the protein that leads to the creation of beta-amyloid. Beta-amyloid fragments
can become plaques in the brain. Symptoms tend to appear 10 to 20 years earlier in people with
Down syndrome than they do for the general population.Sex:Overall there are more women
with the disease because they tend to live longer than men.

Mild cognitive impairment:Someone with mild cognitive impairment (MCI) has a decline
in memory or other thinking skills that is greater than usual for the person's age. But the decline
doesn't prevent the person from functioning in social or work environments.However, people
with MCI have a significant risk of developing dementia. When MCI affects mainly memory, the
condition is more likely to progress to dementia due to Alzheimer's disease. A diagnosis
of MCI offers people the chance to put a greater focus on healthy lifestyle changes and to come
up with strategies to make up for memory loss. They also can schedule regular health care
appointments to monitor symptoms.

Head trauma:Several large studies found that people age 50 years or older who had a
traumatic brain injury (TBI) had an increased risk of dementia and Alzheimer's disease. The risk
is even higher in people with more-severe and multiple TBIs. Some studies found that the risk
may be greatest within the first six months to two years after the injury.

Air pollution:Studies in animals have found that air pollution particulates can speed the
breakdown of the nervous system. And human studies have found that air pollution exposure —
especially from traffic exhaust and burning wood — is linked to a greater dementia risk.

Excessive alcohol consumption:Drinking large amounts of alcohol has long been known
to cause brain changes. Several large studies and reviews found that alcohol use disorders were
linked to an increased risk of dementia — early-onset dementia in particular.

Poor sleep patterns: Research has shown that poor sleep patterns, such as trouble falling
asleep or staying asleep, are linked to an increased risk of Alzheimer's disease.

Lifestyle and heart health:Research has shown that the same risk factors associated with
heart disease also may increase the risk of dementia. It's unclear if these factors increase risk of
dementia by worsening Alzheimer's changes in the brain or by leading to brain vascular changes.
They include:

 Lack of exercise.
 Obesity.
 Smoking or exposure to secondhand smoke.
 High blood pressure.
  High cholesterol.
 Poorly controlled type 2 diabetes.
These factors can all be modified. Therefore, changing lifestyle habits can to some degree alter
your risk. For example, regular exercise and a healthy low-fat diet rich in fruits and vegetables
are related to a lower risk of Alzheimer's disease.

Complications :Alzheimer's symptoms such as memory loss, language loss, impaired

judgment and other brain changes can make it harder to manage other health conditions. A
person with Alzheimer's disease may not be able to:

 Tell someone about being in pain.

 Explain symptoms of another illness.
 Follow a treatment plan.
 Explain medicine side effects.
As Alzheimer's disease moves into its last stages, brain changes begin to affect physical
functions. The changes can affect the ability to swallow, balance, and control bowel and bladder
movements. These effects can lead to other health problems such as:

 Inhaling food or liquid into the lungs.

 Flu, pneumonia and other infections.
 Falls.
 Fractures.
 Bedsores.
 Poor nutrition or dehydration.
 Constipation or diarrhea.
 Dental problems such as mouth sores or tooth decay.

Prevention: Alzheimer's disease is not a preventable condition. However, a number of

lifestyle risk factors can be modified.

Evidence suggests that taking steps to reduce the risk of cardiovascular disease may also lower
your risk of developing dementia.
To follow heart-healthy lifestyle choices that may reduce the risk of dementia:

 Exercise regularly.
 Eat a diet of fresh produce, healthy oils and foods low in saturated fat, such as a
Mediterranean diet.
 Follow treatment guidelines to manage high blood pressure, diabetes and high cholesterol.
 If you smoke, ask your health care professional for help to quit.

How is Alzheimer’s disease treated?

Medical management can improve quality of life for individuals living with Alzheimer’s disease
and for their caregivers. There is currently no known cure for Alzheimer’s disease. Treatment
addresses several areas:

 Helping people maintain brain health.

 Managing behavioral symptoms.
 Slowing or delaying symptoms of the disease.

Alzheimer
Geriatric Disease

Geriatric syndromes are clinical conditions identified more commonly in older adults,
particularly in frail older adults; these conditions are not necessarily attributed to a specific,
isolated underlying disease. The presenting “symptom” of a geriatric syndrome is related to
an accumulation of impairments in multiple systems and the inability of the individual to
compensate for impairments. The etiology underlying the development of geriatric syndromes
is believed to be multifactorial in nature. Conceptually, individuals have a limited amount of
“reserve” to tolerate physiologic stressors. During the aging process, there is a decline in the
homeostatic reserve capacity of all organ systems, thus rendering individuals more susceptible
to stressors.

When stressors overwhelm an individual’s reserve capacity, the development of geriatric

syndromes may be representative of the lack of compensatory ability to manage a particular
stressor. In the oncology setting, this is highly relevant, because cancer and cancer therapies
are potential physiologic stressors and may exacerbate or precipitate geriatric Common
geriatric syndromes include falls, cognitive syndromes and delirium, depression,
polypharmacy, and urinary incontinence. As described previously by Fried et al, the clinical
presentation of the geriatric syndrome frequently does not represent the specific physiologic
stressor that incites the development of the geriatric syndrome on an organ system level (e.g.,
development of delirium in the setting of pneumonia or urinary tract infection). 1 Thus, this
reinforces the multifactorial etiology of geriatric syndromessyndromes.
" However, the term "geriatric" is often used to describe health conditions and concerns that are
more common in older adults. These conditions can include arthritis, osteoporosis, dementia,
cardiovascular diseases, and diabetes, among others.

The term "geriatric" simply refers to the age group of individuals who are typically affected by
these conditions. Geriatric medicine specializes in treating the conditions commonly experienced
by older adults.Numerous variables make treating older adults different from their younger
counterparts, including polypharmacy, vague presentation of symptoms, and challenges with
attribution in cases where multiple health conditions are present at once.Older adults are also more
prone to developing age-related diseases that younger people do not typically develop. High blood
pressure might be an intergenerational problem, but issues like cardiovascular disease, ischemic
heart disease, urinary incontinence, vascular dementia, multiple sclerosis, and other diseases are
far more common among older adults.

Some common geriatric health conditions

1. Arthritis: This is a condition that causes joint inflammation and pain. It can make it
difficult for older adults to move and perform daily activities.

2. Osteoporosis: It's a condition characterized by the loss of bone density, making bones
weak and prone to fractures. It's more common in older women.

3. Dementia: This is a group of conditions that affect memory, thinking, and behavior.
Alzheimer's disease is the most common form of dementia.

4. Cardiovascular diseases: These include conditions like heart disease, stroke, and high
blood pressure. They are more prevalent in older adults and can have serious health implications.

5. Diabetes: This is a chronic condition that affects how the body processes sugar. It requires
careful management of blood sugar levels to prevent complications.

Causes :Geriatric syndromes are believed to develop when an individual experiences

accumulated impairments in multiple systems that compromise their compensatory ability. In older
adults with cancer, the presence of a geriatric syndrome is common and may increase the
complexity of cancer treatment.Geriatric syndromes are multifactorial, and shared risk factors—
including older age, cognitive impairment, functional impairment, and impaired mobility—were
demonstrated across the common geriatric syndromes of pressure ulcers, incontinence, falls,
functional decline, and delirium. The 3 main causes of depression in older people are poor physical
health, social isolation and loss.The major cause of death in the 55-64 age group is cancer followed
by heart disease and injury. In the 75+ age group, the leading cause shifts to heart disease, and
injury drops below Chronic Obstructive Pulmonary Disease (COPD), cerebrovascular diseases,
and pneumonia