The NIA-A Case Study

c) Age-related cognitive impairment (or mild cognitive impairment MCI) – is when an elderly person’s memory starts to wane and they have problems recalling their short term memories, they have difficulty learning new things, their thinking process starts to become reduced and have difficulty concentrating. It is thought that MCI can develop due to alcohol abuse and cognitive decline (poor diet, chronic inflammation, vascular disease and

Prior to diagnosis the individual may show signs of forgetfulness due to an incline in memory functions. They may even show signs of a decline in reasoning and communication

Aging is a universal phenomenon and humans are no exception. Gerontology deals with the psychological, social and biological aspects of aging process. A recent study shows that people aged 85 years and older are expected to augment from 5.3 million people to 21 million as the world reach 2050. In today’s world Gerontology has an enormous role to play so that the senior citizens could be analyzed and their needs may be addressed with compassion and empathy.

As a person ages, theirs body cannot perform the way it used to. This will cause many elderly people to loose their job or choose to go into retirement. Both of these options cause a loss in health care as well and a reduced or exterminated income. Here alone lies a reason that the elderly population is challenged. The elderly population also has a tendency to develop a chronic illness that can be life threatening if not treated or controlled properly. This means that need for health care treatments also increases. At least 40% of those over age 65 will have nutrition-related health problems requiring treatment or management (Gigante, 2012). It is important to realize that 10% of people over the age of 65 and will develop Alzheimer’s disease and 50% of those over the age of 85 will develop this disease (Gigante, 2012). More elderly African American men and women use government aid than white men and women. Therefore, this population will be vulnerable because of the lack of funding, proper health care and insurance.

As the population continues to grow older age and life expectancy increases. As a result continued awareness, study and research concerning

An estimated 47.5 million people suffer from dementia. Every 4 seconds one new case of dementia is diagnosed. Dementia is a term that describes certain symptoms such as impairment to memory, communication and thinking. It is a group of symptoms and not just one illness. Even though one‘s chance of getting dementia increase with age, it is not a part of aging. Dementia is usually diagnosed after a series of assessments that includes a physical evaluation, memory tests, imaging studies and blood work. It affects three aspects of one’s mental function, cognitive dysfunction (Problems with memory, language, thinking and problem solving), psychiatric behavior (changes in personality, emotional control, social behavior and delusions) and difficulties with daily living activities (driving, shopping, eating and dressing). “The median survival time in women is 4.6 years and in men 4.1 years” (Warren, 2016).

The elderly population is growing with 35 million people who are age 65 years or older and half are between the ages of 65 to 74 and the other half are over the age of 75. The population age 85 years or older are the fastest growing population (Dubow, 2017). In 1991 the Institute of Medicine (IOM) reported that 8 out of 10 people over the age of 60 had one or more chronic diseases or impairments which included arthritis, hypertension, hearing impairment, heart disease, cataracts, deformity or orthopedic impairment, chronic sinusitis,

There is evidence from older individuals who are deemed “clinically normal” that the process of Alzheimer’s disease starts way before the clinical diagnosis of dementia, thus suggesting a preclinical stage (Sperling et al., 2011). The criteria for the preclinical stage of Alzheimer’s Disease is broken up in three stages. Stage one consists of the presence of A displacement in the brain, stage two is the displacement of A plus neurodegeneration, and stage three is the displacement of A, neurodegeneration, and subdued cognitive deficiencies. The classification for an individual to be grouped into one of these stages is based on the amount of A levels (low levels in the cerebrospinal fluid, or high levels in the brain) and/or the neurodegenerative process (Burnham, et al., 2016).

By this time the remaining Baby Boomers, totaling an estimated 70 million people, will be at least 65. This is anticipated to have a notable effect on the current health care system. This coupled with the increasing life expectancy and the decrease in number of young people means that the older adult population will make up a much greater percentage of the population then has ever been experienced. This means that unless something is done immediately then health care workforce will lack the ability and size to meet the needs of this growing older population in the future. Many older adults have numerous compound chronic conditions that require a wide range of skills for meeting their many physical and mental needs.

Early dementia is also known as MCI (Mild Cognitive Impairment) and only about half of those with this diagnosis move on to one of the more progressive dementias. So, it is understandable that some in a family might say – “Grandma was just like Dad.” “But, she was able to take care of herself till she was 85.”

This stage people have no memory loss, and they are also mentally healthy at this stage. People in this stage are considered to have no dementia. The second stage is the very mild cognitive stage, this is the stage to use to describe how being forgetful occurs because of old age, for example forgetting people’s names or event. The third stage is the mild cognitive decline, this stage includes increased forgetfulness, slight difficulty with concentrating, and also difficulty finding the right words to communicate with, this occurs 7 years before the onset of dementia. The fourth stage is the moderate cognitive decline, this stage includes difficulty with concentrating, decreased memory of recent activities, difficulty managing finance and travelling alone. It is very difficult to manage complex tasks in this stage, they begin to withdraw form social their life. They won’t want to associate themselves with their family members, and at this stage a physician can detect clear cognitive problems during their visit. It is the early stage of dementia and it occurs within 2 year (Stages of Dementia). The fifth stage is moderately severe cognitive decline, this is the mid stage, and it includes major memory deficiencies. This is the stage where they need assistance with their activities of daily living such as bathing, dressing, and preparing meals. The memory loss is more

Q3: Mild cognitive impairment (MCI) is a decline in cognitive function that does not meet the standards of dementia but is worse than what is expected for the patient’s age and educational background (Petersen et al., 1999). While a patient with MCI is at increased (10-20%) risk of developing Alzheimer’s disease (AD) compared to the normal population, it is not necessary to classify patients as having MCI until they develop any further preclinical AD symptoms (Petersen et al., 1999). The diagnostic criteria for MCI includes: (1) impaired in memory that is greater than expected for age and general cognition is not effected (2) capable of performing daily activities and (3) not demented (Albert et al., 2011; Petersen et al., 1999).

During this step the researcher start reviewing and critique relevant literature. It was concluded that there is a need for a better cognitive tool to identify MCI. If the patient is not diagnosed correctly then treatment could be postponed until their symptoms get worse. Current medications for the treatment of Dementia do not cure the disease they have been shown to lessen or stabilize symptoms. Clinicians are hesitant to start medications on patients unless there is evidence to back the need for the drug. If clinicians do not have the right tools to assist in the diagnosis of Dementia these medications may not be prescribed soon enough. In this step the researcher will sell this problem and question to the

elderly are an ever more important focus of our attention as the aging population grows with

‘Normal’ cognitive aging is the process of the brain aging (Kortebein, 2013, p. 8). This involves the central nervous system aging in the absence of psychiatric diseases, neurodegenerative diseases or related pathology (Kortebein, 2013, p. 8). There is no known or exact cause to explain why the brain ages (Kortebein, 2013, p. 8). But, there are cognitive changes, which occur as individual’s age (Harada, Natelson-Love & Triebel, 2013, p. 1). There are many myths in society that suggest as individual’s age they lose all of their cognitive abilities, but this is not the case (Emory Alzheimer’s Disease Research Centre, n.d., p. 1). While some areas show normal signs of