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14. Neurocognitive Disorders and Disorders Related to Aging Multiple-Choice Questions 1. ______ disorders arise from injuries or diseases that affect the brain, including those that result from drug use or withdrawal. A. Learning B. Neurocognitive C. Developmental D. Neurosurgical Answer: B 2. Disorders involving deficits in cognitive functioning that represent a marked change from the individual’s prior level of functioning and which are caused by physical or medical conditions that affect brain functions are called ______. A. psychosomatic disorders B. adjustment disorders C. neurocognitive disorders D. somatoform disorders Answer: C 3. Neurocognitive disorders differ from other psychological disorders in that they ______. A. result in permanent loss of physical functioning because of psychological factors B. affect men far more than women C. involve deterioration in the functioning of one or more of the five sensory organs D. have either known or presumed biological causes Answer: D 4. Why are disorders that were termed cognitive disorders in earlier versions of the DSM now termed as neurocognitive disorders in the DSM-5? A. to better reflect the fact that cognitive functions are closely linked to particular brain regions and neural pathways B. to deemphasize the stigma attached to these disorders C. to reflect that cognitive tasks such as memory and attention are not as biologically based as we once thought D. to make it more difficult to diagnose Answer: A 5. A disturbance of sensory perception, usually affecting visual recognition, is known as ______. A. aphasia B. amnesia C. agnosia D. delirium Answer: C 6. A woman is unable to process any visual information in a sensible manner. Although her eyes work fine and her brain processes the visual material so that she can "see," her brain processes he visual material in a fragmented manner so she is unable to make any sense out of what she sees. This woman is suffering from ______. A. Pick's disease B. Wernicke's syndrome C. agnosia D. aphasia Answer: C 7. Which of the following is one of the major types of neurocognitive disorders? A. mental retardation B. delirium C. autism spectrum disorder D. nonverbal communication disorder Answer: B 8. The DSM-5 classifies disorders of cognitive functioning by organizing them into ____ types of disorders. A. two B. three C. four D. five Answer: B 9. Which of the following is a general term used to describe a severe neurocognitive disorder in which there is general deterioration of mental functioning? A. dementia B. dissociation C. cognitive slippage D. secondary cognitive decline Answer: A 10. Which of the following is a state of extreme mental confusion in which people have difficulty focusing their attention, speaking clearly and coherently, and orienting themselves to the environment? A. delirium B. dissociation C. cerebral regression D. cerebral inflammation Answer: A 11. The term ______ means straying from the line, or the norm, in cognition, perception, and behavior. A. dementia B. delirium C. aphasia D. agnosia Answer: B 12. A state of mental confusion, disorientation, and inability to focus attention is known as ______. A. amnesia B. dementia C. delirium D. aphasia Answer: C 13. There are ______ known causes of delirium. A. three B. four C. five D. many Answer: D 14. Molly has a cognitive disorder. Her mind wanders. She can't shift attention to new tasks. Her thinking is disorganized and marked by incoherent speech. She is often disoriented, has difficulty staying awake, and sometimes misinterprets sensory stimuli. Her disorder is most likely ______. A. dementia B. delirium C. intoxication D. amnestic disorder Answer: B 15. Viral encephalitis is ____________. A. a prion disease B. a hardening of brain arteries with a viral origin C. a type of brain infection D. a swelling of the brain resulting from a B vitamin deficiency Answer: C 16. Lack of awareness of the date, time, place, and identity is known as ______. A. dementia B. disorientation C. confabulation D. amnesia Answer: B 17. Dr. Jones, after conducting an interview with Patrick’s grandfather (who has delirium), indicates that the grandfather is experiencing “Disorientation to person.” This phrase means that Patrick’s grandfather doesn’t know __________. A. who Patrick is B. who he is C. who the doctor is D. he exists Answer: B 18. The severity of symptoms with delirium ___________. A. steadily becomes more severe over the course of a day B. becomes severe only in the evening C. fluctuates throughout the course of a day D. remains constant for the remainder of the patient’s life Answer: C 19. Visual hallucinations can be a part of ______. A. dementia B. amnesia C. delirium D. senility Answer: C 20. Which of the following can be a symptom of delirium? A. increased appetite B. disorientation C. headache D. depression Answer: B 21. The prevalence of delirium is estimated at about ______ in the general community. A. 1% to 2% B. 5% to 10% C. 10% to 20% D. 30% to 50% Answer: A 22. Among people over the age of 85, the prevalence rate of delirium rises to about ____ percent. A. 6 B. 14 C. 20 D. 50 Answer: B 23. Delirium most often affects which of the following? A. elderly hospitalized patients following surgical operations B. husbands just before marriage C. adolescents during puberty D. athletes during sporting event Answer: A 24. According to the textbook, delirium may also occur due to exposure to which of the following? A. toxic substances such as eating certain poisonous mushrooms B. music played at a subliminal level C. excessive color D. an extreme monotone voice for an extended period of time Answer: A 25. A key feature in delirium is disturbances of _______. A. appetite B. perception C. IQ D. sex drive Answer: B 26. Delirium can be caused by a deficiency in ______. A. vitamin A B. the B vitamin thiamine C. vitamin C D. vitamin D Answer: B 27. Which of the following is a common cause of delirium? A. brain infection B. spider bite C. vitamin C deficiencies D. iron deficiencies Answer: A 28. Among young people, delirium is most commonly the result of which of the following? A. abrupt withdrawal from psychoactive drugs B. a side-effect of medication C. hospitalization D. the pressure of adolescence Answer: A 29. Among older persons, delirium is most likely to be a sign of _____________. A. psychoactive substance use B. alcohol withdrawal C. the onset of Alzheimer’s disease D. a life-threatening medical condition Answer: D 30. Fran’s boyfriend Mark has been brought to the hospital in a delirious state. Mark, age 18, is a first-year college student and has no known psychiatric or medical problems. He seemed fine before going out with his fraternity brothers and he has not been involved in any accident. What might the doctors evaluating Mark initially consider as a possible cause of his delirium? A. psychoactive drugs B. an underlying serious medical condition C. liver disease D. a seizure disorder Answer: A 31. The most common cause of delirium among young people is ______. A. brain infection B. abrupt withdrawal from drugs C. severe head trauma D. ingestion of drugs Answer: B 32. Ed, a chronic alcoholic, has not had a drink in over 24 hours. Ed feels as though there are cockroaches crawling all over him. He is experiencing terrifying hallucinations as well. It is possible Ed is experiencing _______. A. a psychotic break B. a manic episode C. alcohol poisoning D. DTs Answer: D 33. People with chronic alcoholism who abruptly stop drinking may experience a form of delirium called ______. A. delirium tremens B. alcohol reverberation C. intoxication rebound D. synergy aria Answer: A 34. The course of delirium tremens usually runs for about a ______. A. day B. week C. month D. year Answer: B 35. The best treatment setting for delirium tremens would be ________. A. a hospital B. an outpatient clinic C. a nursing home D. at home Answer: A 36. Delirium involves ___________, possibly resulting from ______________. A. an allergic reaction; dehydration B. widespread disruption of brain activity; imbalances in the levels of certain neurotransmitters C. widespread neurotransmitter excess; undetected tumors D. underactivity of neural firing; cognitive decline Answer: B 37. Which of the following differentiates delirium from dementia or other forms of major neurocognitive disorder? A. It develops rapidly, generally in a few hours to a few days. B. It is characterized by states of confusion. C. It results in increased need for sleep. D. It only affects those with lower cholesterol levels. Answer: A 38. Muscle spasms, seizures and tremors are features of delirium which fall into which of the following domains? A. Emotion B. Cognition and perception C. Behavior D. Autonomic nervous system activity Answer: C 39. Apprehension, fear and panic are features of delirium which fall into which of the following domains? A. Emotion B. Cognition and perception C. Behavior D. Autonomic nervous system activity Answer: A 40. Confusion, meaningless mumbling, and wild hallucinations are some of the major and minor features of delirium in which of the following domains? A. Emotion B. Cognition and perception C. Behavior D. Autonomic nervous system activity Answer: B 41. During the course of delirium, the person’s mental state often fluctuates between periods of clarity (“lucid intervals”), which are most common in the __________, and periods of confusion and disorientation. A. morning B. afternoon C. early evening D. middle of the night Answer: A 42. Carl is suffering from delirium. He experiences apprehension, confusion, racing thoughts, tremors, and an abnormally fast heartbeat. His delirium is best described as ______. A. chronic B. mild C. moderate D. severe Answer: B 43. Carl is suffering from delirium. He experiences fear, delusions, some disorientation, muscle spasms, but not seizures, and perspires heavily. His delirium is best described as ______. A. chronic B. mild C. moderate D. severe Answer: C 44. Carl is suffering from delirium. He mumbles incoherently, experiences episodes of panic with vivid and frightening hallucinations, seizures, and high fever. His delirium is best described as ______. A. chronic B. mild C. moderate D. severe Answer: D 45. Which of the following is a symptom of severe delirium? A. meaningless mumbling B. delusions C. muscle spasms D. apprehension Answer: A 46. Marcus exhibits panic, fever, seizures, meaningless mumbling, and vivid hallucinations. His behavior is best described as ______. A. dementia B. schizophrenia C. Alzheimer’s disease D. delirium Answer: D 47. Which of the following represent the feature of autonomic activity with delirium? A. abnormally fast heartbeat B. muscle spasms C. disorientation, delusions D. vivid hallucinations Answer: A 48. Cal suffers from delirium. He is most likely to have moments of clarity ______. A. in the morning B. in the afternoon C. in the evening D. late at night Answer: A 49. Ryan suffers from delirium. He is most likely to have his worst periods of confusion following ______. A. episodes of binge eating B. a night in which he overslept C. a sleepless night D. a stressful day Answer: C 50. Angel suffers from delirium. He is most likely to have his worst periods of confusion in ______. A. the evening, after dark B. the morning C. the presence of bright lights D. a large crowd Answer: A 51. ____________ represents a profound decline or deterioration in mental functioning characterized by significant impairment of memory, thinking processes, and judgment and by specific cognitive deficits. A. Stupor B. Dissociation C. Agnosia D. Delirium Answer: D 52. Which of the following is another word for major neurocognitive disorder? A. dementia B. Korsakoff’s syndrome C. mental retardation D. delirium Answer: A 53. ______ involves a profound deterioration in mental functioning, characterized by gross memory impairment and cognitive deficits such as aphasia, apraxia, or agnosia, and deficits in executive functioning. A. Major neurocognitive disorder B. Delirium C. Anhedonia D. Amnestic disorder Answer: A 54. Most dementias are ______ and ______. A. episodic, reversible B. progressive, reversible C. episodic, irreversible D. progressive, irreversible Answer: D 55. Which of the following is a known cause of dementia? A. febrile convulsions B. HIV infection C. headaches D. aluminum Answer: B 56. The most common form of dementia is ______. A. vascular dementia B. dementia due to Pick's disease C. dementia due to Alzheimer's disease D. dementia due to Parkinson's disease Answer: C 57. Sally has a cognitive disorder. She has memory deficits in recalling newly learned information, past personal information, and common knowledge. She also exhibits deficiencies in abstract thinking, impaired judgment, aphasia, and apraxia. Finally, she exhibits personality changes in which she seems almost the opposite of her normal self. Her disorder is most likely ______. A. dementia B. delirium C. anencephaly D. amnestic disorder Answer: A 58. A form of dementia that results from neurosyphilis is ______. A. AIDS B. general paresis C. delirium D. Creutzfeldt-Jacob Answer: B 59. General paresis is caused by ______. A. an auto-immune disorder B. encephalitis C. neurosyphilis D. meningitis Answer: C 60. Syphilis is caused by a(n) ______. A. bacterial infection B. auto-immune disorder C. viral infection D. environmental toxin Answer: A 61. Andrew suffers from late-stage syphilis. He has slurred speech, impaired motor coordination, and is steadily developing motor paralysis. He is irritable, but lacks normal responsiveness to joyous or upsetting events. He has deteriorated intellectually, and has completely abandoned personal grooming and hygiene. His condition is called ______. A. Huntington's disease B. Addison's disease C. general paresis D. meningitis Answer: C 62. Late-stage syphilis once accounted for upward of ______ percent of admissions to psychiatric hospitals. A. 10 B. 30 C. 50 D. 70 Answer: B 63. In cases of severe tissue damage resulting from neurosyphilis, antibiotics can ______. A. do little to slow the pace of deterioration B. slow down the pace of deterioration but cannot stop it C. stop the deterioration but cannot restore former levels of functioning D. stop the deterioration and eventually restore former levels of functioning Answer: C 64. A form of dementia caused by a bacterium that had historical significance in the development of the medical model of mental disorders was known as which of the following? A. general paresis. B. delirium C. apraxia D. agnosia Answer: A 65. The form of dementia called general paresis resulted from a form of the later stages of which sexually transmitted disease? A. HIV B. chlamydia C. syphilis D. herpes Answer: C 66. The finding that the form of dementia known as general paresis was caused by a bacterium was important for the development and strengthening of which of the following? A. the medical model B. the psychodynamic model C. the cognitive model D. the psychological model Answer: A 67. The 19th-century discovery of the connection between _____ and a concrete physical illness, syphilis, strengthened the medical model and held out the promise that organic causes would eventually be found for other abnormal behavior. A. general paresis B. chlamydia C. Alzheimer’s disease D. vascular neurocognitive disorder Answer: A 68. The effectiveness of treatment for general paresis through the use of antibiotics is dependent upon which of the following? A. when they are introduced and the extent of the brain damage B. the time of day the antibiotics are given and the type of antibiotics C. whether the chlamydia is comorbid with depression D. the type of chlamydia and the diet of the user Answer: A 69. Why did the developers of the DSM-5 decide to no longer use the term dementia as a diagnostic label? A. It is a pejorative term that carries an unfortunate stigma. B. The term is too specific and descriptive. C. The term only applies to young people. D. Prevalence rates of dementia are very low. Answer: A 70. Which of the following is true? A. Dementia is an inevitable and normal part of the aging process. B. Dementia is a sign of degenerative brain disease. C. The risk of dementia decreases after age 70. D. There are relatively few causes of dementia. Answer: B 71. Most dementias occur in people ______. A. under age forty B. between the ages of 40 and 60 C. between the ages of 60 and 80 D. over age 80 Answer: D 72. The form of dementia that begins at or before the age of 65 is called ______. A. presenile dementia B. progressive dementia C. senile dementia D. episodic dementia Answer: A 73. The form of dementia that begins after age 65 is called ______. A. presenile dementia B. progressive dementia C. senile dementia D. episodic dementia Answer: C 74. Impaired ability to comprehend or produce speech is called ______. A. agnosia B. apraxia C. disturbance in executive functioning D. aphasia Answer: D 75. Impaired ability to perform purposeful movements despite an absence of any defect in motor functioning is called ______. A. agnosia B. apraxia C. disturbance in executive functioning D. aphasia Answer: B 76. Inability to recognize objects, despite an intact sensory system is called ______. A. agnosia B. apraxia C. disturbance in executive functioning D. aphasia Answer: A 77. Deficits in planning, organizing, or sequencing activities or in engaging in abstract thinking is called ______. A. agnosia B. apraxia C. disturbance in executive functioning D. aphasia Answer: C 78. Which of the following is a newly recognized disorder in DSM-5 that applies to people who suffer a mild or modest decline in cognitive functioning from their prior level? A. Parkinson’s disease B. Mild neurocognitive disorder C. dementia D. delirium tremens Answer: B 79. Regarding mild neurocognitive disorder, which of the following is a true statement? A. It first appeared in the DSM-IV-TR. B. The decline is not of sufficient magnitude to justify a diagnosis of major neurocognitive disorder. C. Concerns alone about the decline are sufficient for a diagnosis. D. It is a new name for what was once a mood disorder. Answer: B 80. Mild neurocognitive disorder is a new name for a clinical syndrome widely identified as ____________. A. mild cognitive impairment B. delirium C. agnosia D. major neurocognitive disorder Answer: A 81. Mild impairment of cognitive functioning frequently occurs in the ____ of neurodegenerative diseases like AD and other conditions affecting the brain, such as traumatic brain injury, HIV infection, substance-use-related brain disorders, and diabetes. A. early stages B. middle stages C. late stages D. end stage Answer: A 82. Which of the following is a degenerative brain disease that leads to progressive and irreversible dementia and is characterized by memory loss and deterioration of other cognitive functions, including judgment and ability to reason ? A. Korsakoff’s syndrome B. Alzheimer’s disease C. dementia D. Parkinson’s disease Answer: B 83. As the US population continues to grow in the number of older adults, the prevalence rate in the U.S. is expected to _________ in numbers of people by the year _____. A. more than quadruple; 2040 B. more than double; 2040 C. stabilize; 2070 D. more than double; 2020 Answer: B 84. Alzheimer’s patients account for ________ of patients diagnosed with dementia. A. 90% B. 25% C. 50% D. 35% Answer: C 85. Alzheimer’s disease affects more than 1 in _____ people over the age of 65 and more than 1 in ____ people over the age of 85. A. 5; 3 B. 8; 3 C. 14; 5 D. 10; 7 Answer: B 86. Alzheimer’s is _______ not a ______. A. a form of delirium; permanent condition B. an emotional response to aging; biologically-based disorder C. a degenerative form of brain disease; normal sign of aging D. a normal part of aging; preventable disorder Answer: C 87. Women have been found to be at higher risk than men for Alzheimer’s disease. As your authors point it this may be because ______. A. of the effects of estrogen B. the older generation of women have not exercised their brains at work as much as men C. they live longer than men D. they have not exercised as much as men Answer: C 88. Which symptom would be expected in advanced cases of Alzheimer’s disease? A. feeling as though they have a special power over others B. delusions that special messages from the president are being transmitted to the individual through the pet cat’s water bowl. C. delusions of grandeur that they are someone with great power like God or the president D. forgetting their own names Answer: D 89. Alzheimer’s disease was first described by a ______. A. German physician B Swiss psychologist C. American psychiatrist D. Dutch nurse Answer: A 90. Brain plaques and neurofibrillary tangles are common symptoms of ______. A. Korsakoff's syndrome B. Wernicke's disease C. Alzheimer's disease D. Parkinson's disease Answer: C 91. In 2012, a new technology became available that allows doctors to diagnose Alzheimer's disease based on ________ associated with the disease together with clinical evidence of memory loss. A. examination of glucose levels B. brain scans showing plaques C. a complete review of behavioral and neuromuscular deficits D. inspection of brain tissue by a biopsy or autopsy Answer: B 92. Early age of onset of Alzheimer’s disease is associated with ______ cognitive function and a ______ severe form of the disease. A. poorer, less B. poorer, more C. better, less D. better, more Answer: B 93. Limited memory problems and subtle personality changes are early signs of ______. A. Korsakoff’s syndrome B. Alzheimer’s disease C. Wernicke’s disease D. ataxia Answer: B 94. Ben has Alzheimer's disease. Currently, he is having memory problems such as remembering his zip code, telephone numbers, and the names of some of his grandchildren. He also has difficulty managing his finances because he no longer can add two numbers correctly. Although he keeps himself neatly groomed, Ben, who used to be quite outgoing, now stays at home most of the time. Ben's Alzheimer's disease is now at the ______ level of development. A. early B. moderate C. moderately severe D. severe/advanced Answer: A 95. Bob has Alzheimer's disease. Currently, he requires some assistance managing everyday affairs. He is unable to select clothes that are proper for the season or occasion. He is also unable to recall the names and addresses of family members. He shouldn't drive because he forgets which pedal is for the brakes and which one is for the gas. He also forgets what traffic lights and stop signs mean. Bob's Alzheimer's disease is at the ______ level of development. A. early B. moderate C. moderately severe D. severe Answer: C 96. Tim has Alzheimer's disease. Currently, he cannot remember the names and addresses of friends and family members. He also has large gaps in his memory for recent events and experiences. He cannot remember his complete address and he sometimes forgets the name of his spouse, upon whom he is completely dependent. He needs assistance with bathing and toileting. He paces, walking in short, slow steps, and he rarely talks in complete sentences anymore. He is often agitated to the point of acting out his emotions. Tim's Alzheimer's disease is at the ______ level of development. A. mild/early B. moderate C. moderately severe D. severe Answer: C 97. Ron has Alzheimer's disease. Currently, he is incontinent, unable to walk or speak and requires assistance in toileting and feeding. Most times he is entirely mute and inattentive to his environment. Ron's Alzheimer's disease is at the ______ level of development. A. early B. moderate C. moderately severe D. severe Answer: D 98. “Attending a funeral that never ends” is ______. A. the title of a book about a victim of Parkinson’s disease B. the title of a book about a woman who was in a coma from an auto accident for 30 years C. a description of the experiences of the family who cares for an Alzheimer’s patient D. a description of the chronic cognitive and emotional impairment from Korsakoff’s syndrome Answer: C 99. Caregivers of Alzheimer’s patients have been found to have higher ______. A. levels of stress hormones B. incidents of memory loss C. scores on an empathy scale D. suicide rates Answer: A 100. The plaques that characterize Alzheimer's disease are composed of ______. A. aluminum B. fatty triglycerides C. cholesterol D. beta amyloid Answer: D 101. fMRI scans have shown that patients with __________ have less well-connected neural networks in their brains. A. Parkinson’s B. Huntington’s C. Korsakoff’s D. Alzheimer’s Answer: D 102. People with a genetic variant called the _____ gene stand a much higher risk of developing AD. A. Beta amyloid B. Plaque-B C. ApoE4 D. SSRI Answer: C 103. Donepezil, a drug used to treat Alzheimer’s disease, increases levels of ______, a neurotransmitter. A. serotonin B. dopamine C. acetylcholine D. cortisol Answer: C 104. ______ is a drug aimed at treating moderate to severe Alzheimer’s disease by blocking glutamate. A. Leptin B. Niacatil C. Knowitine D. Memantine Answer: D 105. Patients with Alzheimer’s disease tend to have abnormally ______ levels of acetylcholine and abnormally ______ levels of glutamate. A. low, low B. low, high C. high, low D. high, high Answer: B 106. ________ in the brain appears to play a key role in the development of AD. A. Inflammation B. Growth of new neurons C. An enlarged frontal lobe D. Increased corpus callosum activity Answer: A 107. Identify the behavior that has been found to delay the development of Alzheimer’s disease. A. maintaining a daily diary B. participation in mentally challenging tasks C. reducing stress D. taking week-long vacations at least three times per year Answer: B 108. A cerebrovascular accident in the brain is commonly known as a(n) ______. A. aneurysm B. hemorrhage C. laceration D. stroke Answer: D 109. When part of the brain becomes damaged as a result of a disruption of blood supply, it is called a(n) ______. A. aphasia B. cerebrovascular accident C. contusion D. concussion Answer: B 110. Vascular dementia refers to what we now call ______. A. amnestic disorder B. delirium C. vascular neurocognitive disorder D. substance-induced dementia Answer: C 111. Which statement is true of vascular neurocognitive disorder? A. It is the most common form of dementia. B. It occurs typically at a later age than Alzheimer’s disease. C. It affects more women than men. D. It results from a series of repeated strokes. Answer: D 112. Single strokes may produce ______. A. generalized cognitive declines B. vascular dementia C. aphasia D. Alzheimer’s disease Answer: C 113. Vascular neurocognitive disorder is most similar in its symptoms to ______. A. Parkinson’s disease B. Alzheimer’s disease C. delirium D. Huntington’s disease Answer: B 114. As compared to Alzheimer’s dementia, vascular neurocognitive disorder ______. A. does not involve memory impairment B. comes on more abruptly C. comes on more gradually D. does not result in an inability to care for oneself Answer: B 115. Vascular neurocognitive disorder usually results from ______. A. Parkinson’s disease B. a single stroke C. a high fever D. multiple strokes Answer: D 116. Vascular neurocognitive disorder accounts for about one in ______ cases of dementia. A. two B. three C. four D. five Answer: D 117. A disorder that causes Alzheimer's-like symptoms and cognitive deterioration, as well as flagrant sexual behavior and a loss of modesty, but does not involve the presence of plaques and neurofibrillary tangles in the brain is ______. A. Parkinson's disease B. Wernicke's syndrome C. frontotemporal neurocognitive disorder D. Huntington's disease Answer: C 118. Frontotemporal neurocognitive disorder is most similar in its symptomology to ______. A. Parkinson’s disease B. a cerebral hemorrhage C. Alzheimer’s disease D. Huntington’s disease Answer: C 119. Frontotemporal neurocognitive disorder was once called which of the following? A. Parkinson's disease B. Wernicke's syndrome C. Pick’s disease D. Huntington's disease Answer: C 120. A behavioral symptom of frontotemporal neurocognitive disorder is ______. A. loss of modesty B. social withdrawal C. anger displays D. fidgeting Answer: A 121. Frontotemporal neurocognitive disorder disease accounts for about ______ percent of dementias. A. 6 to 12 B. 16 to 22 C. 26 to 32 D. 36 to 42 Answer: A 122. A person is most likely to first show symptoms of frontotemporal neurocognitive disorder during ______. A. childhood B. adolescence C. middle age D. late adulthood Answer: C 123. The risk of contracting frontotemporal neurocognitive disorder declines with age after age ______. A. 40 B. 50 C. 60 D. 70 Answer: D 124. Which of the following people is MOST likely to have Pick’s disease? A. a 40-year-old man B. a 95-year-old man C. a 65-year-old woman D. a 95-year-old woman Answer: A 125. Which of the following is true of frontotemporal neurocognitive disorder? A. It runs in families. B. It is more common in women than in men. C. It is marked by the presence of neurofibrillary tangles. D. Its diagnosis is confirmed by an fMRI. Answer: A 126. Bradley just suffered a severe electric shock. Which of the following cognitive disorders is he MOST likely to develop? A. delirium B. dementia C. amnesia D. organic hallucinosis Answer: C 127. In the text’s excerpt describing the reaction of a male medical student after he awoke from a coma following a head injury, he did not recognize his ______. A. mother B. father C. wife D. daughter Answer: C 128. There are ______ general types of amnesia. A. two B. three C. four D. five Answer: A 129. Loss of memory for personal information and past events is known as ______ amnesia. A. reactive B. pathogenic C. anterograde D. retrograde Answer: D 130. Angie has amnesia. She retains her general intellectual functioning and can learn new information as quickly as ever, but she cannot remember where she lives or anything from her past before she suffered the head injury that left her with amnesia. Her symptoms are most similar to someone with ______ amnesia. A. reactive B. pathogenic C. anterograde D. retrograde Answer: D 131. Inability or difficulty forming or storing new memories is known as ______ amnesia. A. reactive B. pathogenic C. anterograde D. retrograde Answer: C 132. Angie has amnesia. While she remembers everything about her past, she cannot retain memories of any new experiences for more than 10 to 15 minutes. The new memories just seem to “disappear” and she has to learn it all over again. Her symptoms are most similar o someone with ______. A. reactive B. pathogenic C. anterograde D. retrograde Answer: C 133. People with amnestic disorder are most likely to experience disorientation of ______. A. place, but not time or self B. time, but not place or self C. place and time, but not self D. place and self, but not time Answer: C 134. In amnesia, people’s memory ______ and intellectual functioning ______. A. deteriorates, deteriorates B. remains normal, deteriorates C. deteriorates, remains normal D. remains normal, remains normal Answer: C 135. In testing someone with amnesia, the examiner might ask the patient to repeat back a series of numbers that the examiner calls out. This exercise is evaluating ___________. A. long-term memory B. orientation to place C. immediate memory D. retroactive memory Answer: C 136. Immediate memory, as measured by ability to repeat back a series of numbers, seems to be ________ in states of amnesia. A. delayed but available after a period of contemplation B. unimpaired C. significantly impaired D. mildly impaired Answer: B 137. Which of the following cognitive symptoms is someone with amnesia most likely to experience? A. not knowing the day, month, and year B. not knowing their name C. having delusions of grandiosity D. experiencing intense paranoia Answer: A 138. Amnesia patients may suffer profound memory losses and their general intelligence tends to __________. A. deteriorate to the level of borderline intellectual functioning B. remain within a normal range C. temporarily be deficient but return to normal in one to two years D. never recover well enough for the person to live independently Answer: B 139. Sudden loss of oxygen to the brain is called ______. A. infarction B. hypoxia C. hemiplegia D. anaerobia Answer: B 140. Blockage of the blood vessels supplying the brain is called ______. A. anoxia B. cirrhosis C. hemostasis D. infarction Answer: D 141. A common cause of amnestic disorder due to alcohol abuse is ______ deficiency. A. niacin B. iodine C. thiamine D. beta carotene Answer: C 142. Alcohol-induced irreversible memory loss due to brain damage resulting from deficiency of vitamin B1 is another name for ______. A. Cushing's syndrome B. Addison's disease C. Korsakoff's syndrome D. Broca's syndrome Answer: C 143. Korsakoff's syndrome is most closely associated with ______. A. automobile accidents B. posttraumatic stress disorder C. chronic alcohol abuse D. cerebro-vascular accidents Answer: C 144. Long-term thiamine deficiencies may cause an irreversible form of brain damage called ______. A. Korsakoff's syndrome B. Broca's syndrome C. Wernicke's syndrome D. Klinefelter's syndrome Answer: A 145. The memory impairment in Korsakoff’s syndrome ______. A. only involves short-term memory loss B. is reversible as soon as alcohol is out of the patient’s bloodstream C. is caused exclusively by chronic alcoholism D. persists for years after the person stops drinking Answer: D 146. Miles is suffering from Korsakoff’s syndrome. Which memory deficit is most likely? A. vocabulary B. recent experiences C. past experiences D. faces Answer: C 147. Korsakoff's syndrome often follows an acute attack of ______. A. Cushing's syndrome B. Addison's disease C. Wernicke's disease D. Broca's syndrome Answer: C 148. A brain disorder that is associated with chronic alcoholism and characterized by confusion, disorientation, and difficulty maintaining balance while walking is ______. A. Korsakoff’s syndrome B. Wernicke’s disease C. Klinefelter’s syndrome D. dementia Answer: B 149. Shawn suffers from confusion, disorientation, ataxia, and paralysis of the muscles that control eye movements. He is suffering from ______. A. Korsakoff's syndrome B. Broca's syndrome C. Wernicke's disease D. Klinefelter's syndrome Answer: C 150. If one with Wernicke's disease wants to avoid developing Korsakoff’s syndrome, (s)he should be treated with major doses of ______. A. niacin B. thiamine C. carotene D. acetaminophen Answer: B 151. Difficulties in maintaining balance while walking is called ______. A. aphasia B. ataxia C. agnosia D. anhedonia Answer: B 152. Ataxia is ______. A. a disturbance of sensor perception B. impairment in receptive and expressive speech C. difficulty in maintaining balance while walking D. an impaired ability to perform purposeful movements despite an absence of any defect in motor functioning Answer: C 153. Anthony suffers from substantial losses in short-term and long-term memory, although he retains his general level of intelligence. He is superficially friendly but lacks insight and is unable to discriminate between actual events and the wild, implausible stories he invents to fill the gaps in his memory. He is most likely suffering from ______. A. Korsakoff's syndrome B. Broca's syndrome C. Wernicke's disease D. Klinefelter's syndrome Answer: A 154. Which of the following are abnormal protein deposits that form within the nucleus of cells in parts of the brain, disrupting brain processes that control memory and motor control? A. Lewy bodies B. Antibodies C. Korsakoff’s bodies D. Ataxias bodies Answer: A 155. In addition to profound cognitive decline, the distinguishing features of neurocognitive disorder due to Lewy body disease, is ________________ marked by frequent periods of drowsiness and staring to space, as well as recurrent visual hallucinations and rigid body movements and stiff muscles typical of Parkinson’s disease. A. the appearance of fluctuating alertness and attention, B. increased episodes of hunger C. episodes of extreme depression D. episodes of aggression Answer: A 156. Neurocognitive disorder due to Lewy body disease accounts for about _____ of dementias in older adults. A. 10% B. 25% C. 50% D. 70% Answer: A 157. Mark suffers from shaking, tremors, loss of control of fine motor movements, rigidity, and disturbances in posture. He walks laboriously in a crouch and has sluggish reflexes. He usually looks expressionless, as if he were wearing a mask. Mark is probably suffering from ______. A. Parkinson's disease B. Alzheimer's disease C. Pick's disease D. Huntington's disease Answer: A 158. Parkinson's disease afflicts between ______ people in the United States. A. 1,000 to 5,000 B. 10,000 to 15,000 C. 100,000 to 150,000 D. 500,000 to 1,000,000 Answer: D 159. Muhammad Ali and actor Michael J. Fox suffer from ______. A. Alzheimer’s disease B. Pick’s disease C. Parkinson’s disease D. Amnestic disorder Answer: C 160. A woman is ______ as likely as a man to get Parkinson's disease. A. half B. equally C. twice D. four times Answer: B 161. A person is most likely to develop Parkinson's disease between the ages of ______. A. 10 to 29 B. 30 to 49 C. 50 to 69 D. 70 to 89 Answer: C 162. Which statement is true of the incidence of dementia in Parkinson’s patients? A. Dementia is not a symptom of Parkinson’s disease. B. All Parkinson’s patients develop dementia. C. Dementia occurs in as many as 80% of Parkinson’s patients. D. If dementia occurs, it will occur in the early stages of the disease. Answer: C 163. What activity would probably be very difficult for the actor, Michael J. Fox? A. reading a computer monitor B. signing an autograph C. sleeping D. listening to music Answer: B 164. Parkinson’s patients have a greater than average risk of becoming ______. A. hypertensive B. infertile C. mute D. socially withdrawn Answer: D 165. Sufferers of Parkinson's disease are particularly prone to developing ______. A. depression B. generalized anxiety C. schizotypal personality D. conversion disorder Answer: A 166. Parkinson's disease involves destruction of neurons in the ______. A. cochlea B. reticular formation C. caudate nucleus D. substantia nigra Answer: D 167. The substantia nigra is an area of the brain that helps regulate ______. A. short-term memory B. long-term memory C. body movement D. attention and concentration Answer: C 168. In most cases of Parkinson's disease, the underlying causes are ______. A. drug-induced B. viral infection C. atherosclerosis D. unknown Answer: D 169. Parkinson's disease may be related to deficiencies in ______. A. dopamine B. serotonin C. acetylcholine D. cholinesterase Answer: A 170. L-dopa is a drug used primarily to treat ______. A. Parkinson's disease B. Alzheimer's disease C. Pick's disease D. Korsakoff's syndrome Answer: A 171. The majority of Parkinson's patients treated with L-dopa show ______. A. steady improvement and eventual recovery B. stabilization of functioning with few further declines C. temporary improvement followed by gradual deterioration D. temporary improvement followed by rapid deterioration Answer: C 172. Investigators report that which of the following helps block tremors in some Parkinson patients? A. deep brain electrical stimulation B. a diet high in thiamine C. longer periods of sleep D. heavy alcohol use Answer: A 173. Huntington's disease is characterized by progressive deterioration of the ______. A. basal ganglia B. reticular formation C. hippocampus D. substantia nigra Answer: A 174. The basal ganglia helps to regulate ______. A. short-term memory B. long-term memory C. attention and concentration D. body movement and posture Answer: D 175. A person is most likely to develop Huntington's disease between the ages of ______. A. 20 and 30 B. 30 and 45 C. 50 and 70 D. 70 and 90 Answer: B 176. The term chorea used in Huntington’s Chorea refers to ______. A. a characteristic bland facial expression B. a persistently stiff, rigid posture C. involuntary jerky movements D. an uncontrollable, steady outpouring of curse words Answer: C 177. The twitches characteristic of Huntington's disease are termed ______. A. putamen movements B. spastic movements C. choreiform movements D. vernacular movements Answer: C 178. Death usually occurs within ______ years of the onset of Huntington's disease. A. 2-4 B. 7-10 C. 15-20 D. 25-30 Answer: C 179. Jed suffers from involuntary jerky movements of the face, neck, limbs, and trunk. The symptoms began when he was about 43 years of age and have grown progressively worse over the years. He also exhibits progressive dementia with severe memory loss and unstable moods. Lately, he has begun to act paranoid and has begun talking of suicide. Jed is probably suffering from ______. A. Parkinson's disease B. Broca's disease C. Pick's disease D. Huntington's disease Answer: D 180. Folksinger Woodie Guthrie suffered from ______. A. alcoholism B. Pick's disease C. Parkinson's disease D. Huntington's disease Answer: D 181. As with many victims of Huntington’s disease, Woody Guthrie was misdiagnosed with ______ because of his jerky movements. A. alcoholism B. Tourette’s syndrome C. Parkinson’s disease D. tardive dyskinesia Answer: A 182. People who have one parent with Huntington's disease stand a ______ percent chance of contracting the disease themselves. A. 25 B. 50 C. 75 D. 100 Answer: B 183. A person who inherits the defective gene responsible for causing Huntington's disease has a ______ percent chance of developing the disorder. A. 25 B. 50 C. 75 D. 100 Answer: D 184. Huntington’s disease is caused by ______. A. exposure to environmental toxins B. inheriting two recessive genes from parents who carry the disease C. the cumulative effects of multiple strokes D. a single defective gene Answer: D 185. Which of the following is true of dementia due to HIV disease? A. It is common in persons with HIV who have not yet developed full-blown AIDS. B. In advanced stages it may cause delusions, disorientation, and delirium. C. The dementia rarely includes apathy and social withdrawal. D. It is caused by a nutritional deficiency brought on by HIV-related malabsorption in the gut. Answer: B 186. In its later stages, dementia due to HIV disease resembles the deficits found in ______. A. alcoholism B. depression C. Alzheimer's disease D. Huntington's disease Answer: C 187. Which of the following illnesses that produce dementia have a genetic component A. Huntington’s disease B. secondary impact syndrome C. AIDS D. lead poisoning Answer: C 188. Folk singer Arlo Guthrie, whose father died of Huntington’s disease, had the opportunity to obtain genetic testing to ascertain if he had inherited the gene that would cause this disease. What did Arlo decide and what was the outcome? A. He had genetic testing and was found not to be genetically susceptible. B. He chose not to have genetic testing and did not develop the disease. C. Genetic testing found that he was a carrier and he was successfully treated. D. He chose not to have genetic testing but is now incapacitated by the disease. Answer: B 189. Common behavioral features of dementia associated with HIV disease are ___________. A. aggression and paranoid delusions B. loss of language function and paranoia C. apathy and social withdrawal D. hyperactivity and verbal outbursts Answer: C 190. Creutzfeld-Jacob disease is a _________ that results in the e formation of small ___________ in the brain. A. aluminum accumulation; neurofibrillary plaques and tangles B. prion disease; cavities that resemble the holes in a sponge C. flexible bodies disease; round disc-like calcifications D. vascular disease; bundles of plaque Answer: B 191. Creutzfeldt-Jacob disease is a ______ and ______ brain disease. A. common, mild B. rare, mild C. common, chronic D. rare, fatal Answer: D 192. Symptoms of Creutzfeldt-Jacob disease typically become apparent in persons in the ______ age range. A. early 20s B. late 40s C. late 50s D. early 80s Answer: C 193. Death from Creutzfeldt-Jacob disease typically occurs ______ onset of symptoms. A. within days of B. within weeks of C. within months of D. several years after Answer: C 194. The human form of mad-cow disease, a fatal illness spread by eating infected beef, is a variant of _______. A. Huntington’s disease B. Parkinson’s disease C. vascular dementia D. Creutzfeldt-Jacob disease Answer: D 195. As people age, their sharpest cognitive decline occurs on ______. A. long-term memory tasks B. arithmetic C. timed tasks D. vocabulary Answer: C 196. Which cognitive function is typically retained best by the elderly? A. short-term memory B. performance on timed tasks C. vocabulary D. spatial ability Answer: C 197. Memory for ______ would be particularly reduced in the elderly. A. earlier events in their lives B. names C. vocabulary D. faces Answer: B 198. What distinguishes the decline in intellectual functioning in dementia from the decline in normal aging? A. Victims of dementia have difficulty chiefly with long term memory. B. People with dementia have almost always suffered a stroke. C. The normal elderly show no memory loss. D. The decline in dementia victims is much more rapid and severe. Answer: D 199. The most commonly occurring psychological disorder among older adults is ______. A. depression B. anxiety disorder C. hypochondriasis D. dissociative disorder Answer: B 200. What percentage of Americans over the age of 55 are estimated to have diagnosable anxiety disorders? A. 1 B. 5 C. 10 D. 15 Answer: C 201. Which of the following is one of the less common anxiety disorders, occurring in about 1 in 100 older people? A. panic disorder B. generalized anxiety C. phobic disorder D. depression Answer: A 202. The most frequently occurring anxiety disorders among older people are ______. A. panic disorder and obsessive-compulsive disorder B. obsessive-compulsive disorder and phobic disorder C. phobic disorder and generalized anxiety disorder D. generalized anxiety disorder and panic disorder Answer: C 203. Helen is a 66-year-old widow who has been diagnosed with generalized anxiety disorder. Which class of medication is most likely to be used in treating her symptoms? A. benzodiazepines B. phenothiazines C. mood stabilizers D. antidepressants Answer: A 204. Although not enough to warrant a diagnosis, about one in _____ older adults experience some symptoms of depression. A. two B. three C. five D. ten Answer: B 205. Between ______ percent of older adults suffer from major depressive disorder. A. 1 and 5 B. 10 and 15 C. 20 and 25 D. 30 and 35 Answer: A 206. Among older males, suicide is most frequent among those who are ______. A. Hispanic American B. Asian American C. White American D. African American Answer: C 207. Suicide is most frequent among ______ who suffer from depression. A. teenage girls B. teenage boys C. older adult females D. older adult males Answer: D 208. In a study of elderly African American men, ______ was found to be associated with poorer psychological well-being. A. financial concern B. marital conflict C. racism D. being a military veteran Answer: C 209. In a study of elderly African Americans, it was found that compared to women, men experienced ______ institutional racism and ______ collective racism. A. less, less B. greater, less C. less, greater D. greater, greater Answer: D 210. A study of older Mexican Americans found that ______. A. those who were minimally acculturated to the United States had the highest rates of depression B. those who were highly acculturated to the United States had the highest rates of depression C. those who were bicultural had the highest rates of depression D. there were no differences in rates of depression among those minimally acculturated to the United States, highly acculturated to the United States, and those who were bicultural Answer: A 211. In ______, depression may result not only from coping with the illness but also from neurobiological changes in the brain caused by the illness. A. diabetes B. Parkinson’s disease C. hypertension D. atherosclerosis Answer: B 212. Older adults who have declining physical health are at greatest risk for developing depression if they ______. A. do not retire B. are stubborn and argumentative C. lack social support D. lack television and radio Answer: C 213. Which of the following is known to reduce the risk of depression in older adults? A. availability of social support B. being financial well off C. living alone D. caring for a family member with Alzheimer’s disease Answer: A 214. John is a 74-year-old retiree whose wife died two years ago. He lives alone. He has complained to his primary care physician of numerous physical problems, sleep problems, and memory problems. Alzheimer’s disease was ruled out by a psychiatrist specializing in the elderly who probably instead primarily diagnosed John as having ______. A. an anxiety disorder B. a depressive disorder C. amnestic disorder D. a sleep disorder Answer: B 215. The most common sleep problem faced by the elderly is ______. A. insomnia B. narcolepsy C. sleep apnea D. night terrors Answer: A 216. Long-term use of sleep medications among the elderly can lead to ______. A. cardiovascular problems B. insomnia C. hypertension D. dependence Answer: D True-False Questions 217. A neurocognitive symptom that involves a lack of visual knowledge is referred to as visual agnosia. Answer: True 218. The DSM-5 organizes disorders of cognitive functioning into three types of disorders: delirium, major neurocognitive disorder, and mild neurocognitive disorder. Answer: True 219. People who suffer from neurocognitive disorders rarely become completely dependent on others to meet basic needs in feeding, toileting, and grooming. Answer: False 220. Delirium involves a widespread disruption of brain activity, possibly resulting from imbalances in the levels of certain neurotransmitters. Answer: True 221. People with chronic alcoholism who abruptly stop drinking may experience a form of delirium called delirium tremens, or DTs. Answer: True 222. Neurosyphilis is a form of early-stage syphilis. Answer: False 223. In cases of neurosyphilis, the bacterium directly attacks the brain, resulting in dementia. Answer: True 224. The term dementia is used as a diagnostic label in the DSM-5 for describing cognitive impairments in older adults. Answer: False 225. Dementia that begins at age 65 or earlier is termed senile dementia. Answer: False 226. Mild neurocognitive disorder is a new name for a clinical syndrome widely identified as mild cognitive impairment (MCI). Answer: True 227. The great majority of cases of AD occur in people over the age of 65, most typically in those in their late 70s and 80s. Answer: True 228. Forgetting where you put your keys is a normal occurrence; forgetting where you live is not. Answer: True 229. In 2012, new brain scanning technology became available that allows doctors to diagnose AD based on brain scans showing plaques associated with the disease together with clinical evidence of memory loss. Answer: True 230. The early stages of AD are marked by limited memory problems and subtle personality changes. Answer: True 231. In moderately severe Alzheimer’s disease, people require little assistance in managing everyday tasks. Answer: False 232. Caregivers of persons with Alzheimer’s disease tend to experience more health-related problems and higher levels of stress hormones than do no caregivers. Answer: True 233. People with a genetic variant called the ApoE4 gene stand a much lower risk of developing Alzheimer’s disease. Answer: False 234. Donepezil (brand name Aricept) is a widely used drug used to treat Alzheimer’s by increasing levels of the neurotransmitter acetylcholine (ACh). Answer: True 235. Inflammation in the brain appears to play a key role in the development of Alzheimer’s disease. Answer: True 236. Lifestyle factors such as maintaining a regular exercise program and following a healthy diet low in animal fat and rich in vegetables and fish can reduce the risk of Alzheimer’s disease. Answer: True 238. Engaging in stimulating cognitive activities—solving puzzles, reading newspapers, playing word games, etc.—does not help boost cognitive performance in people with mild to moderate AD. Answer: False 237. A cerebrovascular accident (CVA), occurs when part of the brain becomes damaged because of a disruption in its blood supply. Answer: True 239. Vascular neurocognitive disorder is a form of major or mild neurocognitive disorder resulting from cerebrovascular events. Answer: True 240. Vascular dementia is the most common form of dementia. Answer: False 241. Vascular forms of dementia generally result from multiple strokes occurring at different times that have cumulative effects on a wide range of mental abilities. Answer: True 242. Some cognitive functions in people with vascular dementia remain relatively intact in the early course of the disorder. Answer: True 243. Vascular dementia is characterized by an insidious onset and a gradual decline of mental functioning. Answer: False 244. Frontotemporal neurocognitive disorder is characterized by deterioration (thinning or shrinkage) of brain tissue in the frontal and temporal lobes of the cerebral cortex. Answer: True 245. Diagnosis of Pick’s disease is confirmed only upon autopsy by the absence of the neurofibrillary angles and plaques that are found in AD and by the presence of Pick’s bodies in nerve cells. Answer: True 246. Amnesia (memory loss) frequently follows a traumatic event, such as a blow to the head, an electric shock, or a major surgical operation. Answer: True 247. Anterograde amnesia is a loss of memory of past events and personal information. Answer: False 248. Retrograde Amnesia is an inability or difficulty forming or storing new memories. Answer: False 249. Hypoxia is a blockage of the blood vessels supplying the brain. Answer: False 250. People with Korsakoff’s syndrome have major gaps in their memory of past experiences and significant difficulty learning new information. Answer: True 251. Korsakoff’s syndrome involves irreversible memory loss due to brain damage resulting from deficiency of vitamin B1. Answer: True 252. Wernicke’s disease is caused by abnormal protein deposits that form within the nucleus of cells in parts of the brain. Answer: False 253. Lewy bodies are abnormal protein deposits that form within the nucleus of cells in parts of the brain, disrupting brain processes that control memory and motor control. Answer: True 254. Parkinson’s disease is characterized by uncontrollable shaking or tremors, rigidity, disturbances in posture (leaning forward), and lack of control over body movements. Answer: True 255. The form of dementia associated with Parkinson’s disease typically involves delusions and a loss of working memory. Answer: False 256. Parkinson’s disease involves destruction of dopamine-producing nerve cells in the substantia nigra. Answer: True 257. Strattera can help control the symptoms of Parkinson’s disease and slow its progress. Answer: False 258. Huntington’s disease typically begins in the prime of adulthood, between the ages of 30 and 45. Answer: True 259. In Huntington’s disease, there is progressive deterioration of the cerebellum. Answer: False 260. Huntington’s disease is transmitted genetically from the father to male biological children. Answer: False 261. A genetic test can determine whether a person carries the defective gene that causes Huntington’s disease. Answer: True 262. The human immunodeficiency virus (HIV), which causes AIDS, can invade the central nervous system and cause a minor or major neurocognitive disorder. Answer: True 263. Dementia is common in people with HIV who have not yet developed full-blown AIDS. Answer: False 264. The best known example of prion disease is Creutzfeldt-Jakob disease, a rare but fatal brain disease. Answer: True 265. It is normal for people in later life to experience some decline in memory functioning and general cognitive ability, as measured by tests of intelligence, or IQ tests. Answer: True 266. As we age, some abilities, such as vocabulary and accumulated store of knowledge, hold up well and may actually improve over time. Answer: False 267. The most frequently occurring anxiety disorders among older adults are panic disorder and social phobia. Answer: False 268. Estimates are that between 1% and 5% of older adults are currently suffering from a diagnosable major depressive episode Answer: True 269. A study of Mexican American older adults showed that those who were minimally acculturated to U.S. society had lower rates of depression than either highly acculturated or bicultural individuals. . Answer: False 270. Social support for older adults can help buffer the effects of stress, bereavement, and illness, thereby reducing the risk of depression. Answer: True 271. Sleep problems are common in old age and upward of 50% of older adults report sleep problems. Answer: True Essay Questions 272. Discuss the nature of cognitive disorders and briefly describe the various types of neurocognitive disorders. Answer: Nature of Cognitive Disorders and Types of Neurocognitive Disorders: Nature of Cognitive Disorders: Cognitive disorders involve impairments in cognitive functions such as memory, attention, learning, and problem-solving. These disorders can affect various aspects of mental functioning, often resulting from underlying medical conditions, neurological disorders, or substance use. Types of Neurocognitive Disorders: 1. Alzheimer's Disease: Progressive decline in memory and cognitive abilities, leading to significant impairment in daily functioning. 2. Vascular Neurocognitive Disorder: Caused by impaired blood flow to the brain, resulting in cognitive decline due to strokes or other vascular issues. 3. Frontotemporal Neurocognitive Disorder: Affects frontal and temporal lobes, leading to changes in behavior, language, and personality. 4. Lewy Body Dementia: Involves abnormal protein deposits in the brain, causing fluctuations in cognition, visual hallucinations, and motor disturbances. 5. Parkinson's Disease Dementia: Cognitive decline associated with Parkinson's disease, including problems with memory, attention, and executive function. Each type of neurocognitive disorder has distinct symptoms, progression, and underlying causes, requiring specific diagnostic criteria and treatment approaches. 273. What are delirium tremens? What causes this condition? How should it be dealt with medically? Answer: Delirium Tremens (DTs): Description: Delirium Tremens (DTs) is a severe form of alcohol withdrawal syndrome characterized by sudden and severe confusion, hallucinations, and autonomic nervous system hyperactivity. Causes: DTs typically occur in individuals with a history of heavy alcohol use who abruptly stop drinking or significantly reduce alcohol intake. It is a result of alcohol withdrawal affecting neurotransmitter balance in the brain. Medical Management: • Hospitalization: DTs require hospitalization for close monitoring, supportive care, and treatment of severe symptoms. • Benzodiazepines: Medications such as diazepam or lorazepam are commonly used to manage agitation, seizures, and reduce the risk of complications. • Fluids and Electrolytes: IV fluids to correct dehydration and electrolyte imbalances due to alcohol withdrawal. • Other Supportive Care: Nutritional support, management of co-occurring medical conditions, and prevention of complications. Early recognition and prompt medical intervention are crucial to managing DTs and reducing associated risks. 274. Define delirium. Discuss the causes of delirium, its course and periods of intense and less intense symptoms. Answer: Delirium: Definition: Delirium is a state of acute confusion and altered consciousness characterized by disturbances in attention, cognition, and perception. Causes: Delirium can result from various medical conditions, infections, medication side effects, or metabolic imbalances affecting brain function. Course and Symptoms: • Onset: Delirium typically develops rapidly over hours to days, often fluctuating in severity throughout the day. • Symptoms: Hallucinations, disorientation, impaired attention, agitation, and disturbances in sleep-wake cycle. • Hyperactive vs. Hypoactive: Delirium can present as hyperactive (agitated) or hypoactive (lethargic), depending on underlying causes and individual factors. Treatment: Addressing the underlying medical cause is essential. Management includes: • Medical Evaluation: Identifying and treating the precipitating cause (e.g., infection, medication adjustment). • Supportive Care: Providing a calm environment, reorienting the patient, ensuring safety, and managing symptoms with medications if necessary. • Monitoring: Continuous monitoring of vital signs, mental status, and response to treatment. 275. Describe why the term dementia is no longer used as a diagnostic label in the DSM-5. Answer: Use of the Term Dementia in DSM-5: The term "dementia" is no longer used as a diagnostic label in the DSM-5 due to several reasons: • Broadness and Inaccuracy: "Dementia" was considered a broad and imprecise term encompassing various conditions with different underlying causes and symptoms. • Shift to Specific Diagnoses: DSM-5 emphasizes specific diagnoses such as Alzheimer's disease, vascular neurocognitive disorder, and other neurocognitive disorders based on distinct clinical criteria. • Precision in Diagnosis: Specific diagnoses allow for more accurate assessment, treatment planning, and research into different types of neurocognitive disorders. By using specific diagnostic criteria for neurocognitive disorders, clinicians can provide tailored interventions and support based on the unique characteristics and progression of each condition. 276. Describe mild neurocognitive disorder and discuss why its inclusion in the DSM-5 is important from a treatment standpoint. Answer: Mild Neurocognitive Disorder (MND) in DSM-5: Description: Mild Neurocognitive Disorder (MND) is characterized by modest cognitive decline from a previous level of performance in one or more cognitive domains (e.g., memory, executive function) that does not significantly impair daily functioning. Importance from a Treatment Standpoint: • Early Identification: MND allows for early identification of cognitive decline before it progresses to a more severe stage. • Intervention Opportunities: Early diagnosis facilitates timely interventions such as cognitive training, lifestyle modifications, and pharmacotherapy. • Preventative Measures: Addressing risk factors and promoting healthy behaviors can potentially slow cognitive decline and improve quality of life. • Patient and Caregiver Education: Helps educate patients and caregivers about the condition, coping strategies, and available support services. 277. Discuss the findings with regard to the genetic link to Alzheimer’s disease. Answer: Genetic Link to Alzheimer’s Disease: Findings: • APOE Gene: Variants of the apolipoprotein E (APOE) gene, particularly APOE ε4 allele, are associated with increased risk and earlier onset of Alzheimer's disease. • Early-Onset Alzheimer’s: Mutations in genes such as APP (amyloid precursor protein), PSEN1 (presenilin 1), and PSEN2 (presenilin 2) can cause early-onset familial Alzheimer’s disease. • Complex Interaction: Alzheimer's disease is influenced by complex interactions between genetic susceptibility and environmental factors. • Research Advances: Genetic research helps in understanding disease mechanisms, developing biomarkers, and potential targeted therapies. 278. What lifestyle practices can contribute to lessening or slowing the progression of Alzheimer’s disease? Answer: Lifestyle Practices to Lessen or Slow Alzheimer’s Disease Progression: Effective Practices: • Physical Exercise: Regular aerobic exercise promotes brain health, reduces inflammation, and enhances cognitive function. • Healthy Diet: Mediterranean diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids may reduce risk and slow progression. • Mental Stimulation: Engaging in mentally stimulating activities such as puzzles, reading, and learning new skills supports cognitive reserve. • Social Engagement: Maintaining social connections and participating in meaningful activities can support emotional well-being and cognitive health. • Management of Cardiovascular Risk Factors: Controlling hypertension, diabetes, obesity, and cholesterol levels helps protect brain health. • Quality Sleep: Adequate sleep supports memory consolidation and overall brain function. 279. Discuss the similarities and differences between Alzheimer’s disease and Vascular neurocognitive disorder. Answer: Similarities and Differences Between Alzheimer’s Disease and Vascular Neurocognitive Disorder: Similarities: • Both are types of neurocognitive disorders involving cognitive impairment. • Symptoms may include memory loss, executive dysfunction, and impaired daily functioning. Differences: • Cause: Alzheimer's disease is primarily caused by amyloid plaques and tau tangles in the brain, while Vascular Neurocognitive Disorder results from impaired blood flow due to stroke or vascular disease. • Progression: Alzheimer's disease typically progresses gradually, while Vascular Neurocognitive Disorder progression may be more abrupt and related to stroke events. • Risk Factors: Cardiovascular risk factors (e.g., hypertension, diabetes) play a prominent role in Vascular Neurocognitive Disorder, whereas genetic factors like APOE ε4 allele are more associated with Alzheimer's disease. • Treatment Approach: Treatment strategies differ based on underlying causes, with Alzheimer's focusing on symptom management and disease-modifying therapies, while Vascular Neurocognitive Disorder management includes vascular risk factor control and stroke prevention. 280. Describe how regressive dementia due to traumatic brain injury is more likely to result from multiple head traumas. Answer: Regressive Dementia Due to Traumatic Brain Injury (TBI): Description: Regressive dementia refers to a decline in cognitive functioning following a traumatic brain injury (TBI), typically involving multiple head traumas. Factors Contributing to Multiple Head Traumas: • Cumulative Damage: Each head trauma increases the risk of neurodegenerative changes, including accumulation of tau protein and neurofibrillary tangles. • Chronic Traumatic Encephalopathy (CTE): Repetitive brain trauma, such as in contact sports or military service, can lead to CTE, characterized by progressive cognitive decline, mood disturbances, and behavioral changes. • Neurological Consequences: TBI-related dementia may result in memory loss, executive dysfunction, and personality changes, impacting daily functioning. Management: • Early Intervention: Prompt medical evaluation and management of acute TBI to minimize long-term neurological sequelae. • Monitoring: Long-term monitoring for cognitive changes and early signs of dementia. • Supportive Care: Multidisciplinary approach including cognitive rehabilitation, psychological support, and symptom management tailored to individual needs. 281. Discuss the features and causes of amnesia. Differentiate between the two types of amnesia presented in the text. Answer: Features and Causes of Amnesia; Differentiating Types: Features of Amnesia: Amnesia refers to partial or complete loss of memories that were previously stored in the brain. Features include: • Types: Retrograde amnesia (loss of memories before the event) and anterograde amnesia (inability to form new memories after the event). • Causes: Brain injury (e.g., trauma, stroke), neurodegenerative diseases (e.g., Alzheimer's), psychological trauma (e.g., dissociative amnesia), or substance abuse. Differentiating Types: • Retrograde Amnesia: Involves loss of memories before the onset of amnesia, often due to brain trauma or neurological conditions. • Anterograde Amnesia: Impairs the ability to form new memories following an event or injury, affecting daily functioning and learning abilities. 282. Discuss the origins and features of Korsakoff's syndrome. Describe its relationship with Wernicke’s disease. Answer: Origins and Features of Korsakoff's Syndrome; Relationship with Wernicke’s Disease: Korsakoff's Syndrome: • Origins: Typically caused by severe thiamine (vitamin B1) deficiency, often due to chronic alcohol misuse or malnutrition. • Features: Severe anterograde and retrograde amnesia, confabulation (filling in memory gaps with false information), and impaired executive function. • Relationship with Wernicke’s Disease: Wernicke’s encephalopathy precedes Korsakoff's syndrome and is characterized by acute confusion, ataxia, and eye movement abnormalities. Without treatment, Wernicke’s can progress to Korsakoff's syndrome. 283. What is Lewy Body Disease? Discuss its commonalities with Alzheimer’s. How does Lewy Body disease affect mood? Answer: Lewy Body Disease: Description: Lewy Body Disease (LBD) is a progressive neurodegenerative disorder characterized by the accumulation of alpha-synuclein protein deposits (Lewy bodies) in the brain. • Commonalities with Alzheimer’s: Both LBD and Alzheimer’s disease involve cognitive decline, memory impairment, and behavioral changes. • Affects Mood: LBD commonly affects mood and behavior, leading to fluctuations in alertness, visual hallucinations, and symptoms of depression and anxiety. 284. Discuss the treatments currently in use for Parkinson’s disease. How do they treat symptoms? Answer: Treatments for Parkinson’s Disease: Current Treatments: • Medications: Dopamine agonists (e.g., levodopa), MAO-B inhibitors, and anticholinergic drugs to manage motor symptoms such as tremors, rigidity, and bradykinesia. • Deep Brain Stimulation (DBS): Surgical procedure involving implantation of electrodes in specific brain regions to regulate abnormal neuronal activity and alleviate motor symptoms. • Physical Therapy: Exercises to improve mobility, balance, and muscle strength, reducing the impact of Parkinson’s on daily activities. Symptom Management: • Dopamine Replacement: Levodopa converts to dopamine in the brain, compensating for dopamine deficiency in Parkinson’s patients. • Neuroprotective Strategies: Research into medications and lifestyle interventions aimed at slowing disease progression and preserving neuronal function. 285. How is Huntington’s disease acquired? What are its features and course of the disease? Answer: Huntington’s Disease: Acquisition and Features: • Genetic Basis: Inherited autosomal dominant disorder caused by a mutation in the huntingtin gene (HTT) on chromosome 4. • Symptoms: Progressive motor dysfunction (e.g., chorea, dystonia), cognitive decline (e.g., impaired reasoning, memory loss), and psychiatric symptoms (e.g., depression, irritability). • Course of Disease: Onset typically occurs in mid-adulthood, with symptoms worsening over time, leading to significant disability and reduced life expectancy. 286. Discuss different aspects of the controversy regarding genetic testing for diseases which can lead to cognitive impairment. Answer: Controversy Regarding Genetic Testing for Diseases Leading to Cognitive Impairment: Aspects of Controversy: • Ethical Concerns: Issues surrounding privacy, confidentiality, and potential discrimination based on genetic information. • Psychological Impact: Anxiety and distress caused by learning about genetic predisposition to incurable diseases. • Clinical Utility: Debate over the effectiveness of early detection versus the lack of definitive treatments for many genetic conditions. • Family Dynamics: Impact on family relationships and decision-making regarding testing and disclosure of genetic results. 287. What is Creutzfeldt-Jakob disease? Explain the physical process of this disease and the role of the prion. Answer: Creutzfeldt-Jakob Disease (CJD): Physical Process: • Description: Rare, rapidly progressive neurodegenerative disorder caused by abnormal prion proteins. • Role of Prion: Prions are misfolded proteins that induce normal proteins in the brain to become misfolded, leading to widespread damage and formation of spongiform brain tissue. • Symptoms: Rapidly worsening dementia, movement abnormalities, and behavioral changes. • Types: Sporadic CJD (most common), variant CJD (linked to consumption of infected beef), and familial/genetic CJD (inherited mutations). 288. Describe the changes in intellectual functioning as a function of aging. Answer: Changes in Intellectual Functioning as a Function of Aging: Normal Aging: • Cognitive Decline: Mild decline in processing speed, working memory, and episodic memory retrieval. • Wisdom and Expertise: Accumulation of knowledge and expertise compensates for some cognitive changes. • Healthy Aging: Ability to adapt and use strategies to maintain cognitive function, engage in lifelong learning, and participate in social activities. Pathological Changes: • Neurodegenerative Disorders: Alzheimer's disease, vascular dementia, and other forms of neurocognitive disorders lead to progressive cognitive decline and functional impairment. • Treatment and Management: Early detection, lifestyle modifications, cognitive training, and pharmacological interventions can slow cognitive decline and improve quality of life. 289. What are the two most common anxiety disorders among the elderly? What are the likely sources of these disorders? Answer: Anxiety Disorders Among the Elderly: Common Disorders: • Generalized Anxiety Disorder (GAD): Excessive worry and anxiety about everyday life events or activities. • Panic Disorder: Recurrent panic attacks characterized by sudden fear or discomfort, often accompanied by physical symptoms (e.g., palpitations, sweating). Sources: • Health Concerns: Chronic illnesses, pain, and disability associated with aging. • Loss and Bereavement: Grief, loneliness, and social isolation due to loss of friends, family, or spouse. • Cognitive Decline: Fear of dementia or memory loss. • Environmental Stressors: Financial concerns, changes in living arrangements, and caregiver stress. 290. What physical and psychological factors can contribute to depression in the elderly? Discuss the unique stressors that the older person deals with. Answer: Depression in the Elderly: Contributing Factors: • Physical Health: Chronic illnesses, pain, and disability increase risk of depression. • Neurological Changes: Brain changes affecting mood regulation and neurotransmitter function. • Psychological Factors: Loss of independence, grief, and feelings of worthlessness or hopelessness. • Social Isolation: Loneliness, reduced social support, and loss of social roles. • Unique Stressors: Retirement, financial insecurity, and adjustment to life transitions (e.g., widowhood, relocation). 291. Discuss the prevalence of sleep problems with the elderly. What types of psychological and psychosocial difficulties contribute to an elderly person’s sleep problems? Answer: Sleep Problems in the Elderly: Prevalence: • Insomnia: Difficulty falling or staying asleep. • Sleep Apnea: Breathing interruptions during sleep, leading to daytime sleepiness and fatigue. • Restless Legs Syndrome: Uncomfortable sensations in legs causing an urge to move, disrupting sleep. Contributing Factors: • Physical Health: Chronic pain, nocturia (frequent urination), and medical conditions affecting sleep. • Psychosocial Difficulties: Anxiety, depression, and stress impacting sleep quality. • Medications: Side effects of medications used to treat chronic conditions. • Circadian Rhythm Changes: Age-related changes in sleep-wake cycle and decreased production of melatonin. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162

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