Read e-book online Clinical manual of geriatric psychiatry PDF

By James E Spar; Asenath La Rue

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Longitudinal designs also have been used to study normal aging. These investigations track the same individuals over years, or even decades. The least healthy and able subjects are often the first to drop out from these samples, so longitudinal investigations may provide an overly optimistic estimate of the extent of decline with age. The best picture of normative aging trends is obtained from studies in which multiple cohorts are assessed longitudinally or by combining the results of separate cross-sectional and longitudinal studies.

2003). These modes of educating most effectively remediate, or compensate for, reduced speed of processing and working memory or sensory limitations. Clinical Implications of Cognitive Change Cognitive declines that accompany normal aging complicate detection and diagnosis of organic mental disorders. One common error is overdiagnosis of dementia, particularly in persons with limited education. In one large multicultural study, most old persons without dementia who had less than 5 years of education were rated with standard mental status examinations as impaired (Wilder et al.

If older individuals are explicitly instructed to use mnemonics or organizational strategies, their learning and recall often improve dramatically, at least in the short term. Active encoding and retrieval may require greater expenditure of effort and energy than most older people can afford. Declines in effortful processing may be caused by altered neurotransmitter functions (especially catecholamines). Alternatively, such processing changes may be seen as an adaptive response to the diminished demands of older adults’ everyday lifestyles.

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