Geriatric Psychiatry.ppt

Geriatric Psychiatry Anita S. Kablinger MD Associate Professor Psychiatry and Pharmacology Objectives: Differentiate between the various cognitive disorders Know aspects of normal aging Gain knowledge of the best treatment options for geriatric psychiatric illnesses Why is it a subspecialty? Mental disorders may have different manifestations, pathogenesis, and pathophysiology from younger adults Coexisting chronic medical illness More medicines Cognitive impairments Increased risk for social stressors, including retirement and widowhood Geriatric population increasing 2000, estimated that 1 in 5 Americans were over 55 years of age, and 13% over 65 years of age By 2050, estimates are that 22% will be over the age of 65, and 5% over age 85. Aging and the Life Cycle (Erickson) Young adulthood--intimacy versus isolation Middle-aged--generativity versus self-absorption Elderly--Integrity versus despair (Acceptance of mortality, satisfaction with one’s meaning in the world) Fear of death is usually a mid-life issue Other tasks of elderly Reminiscence is normative Loss On-time normative incidents do not usually result in crisis Fears are usually pain, disability, abandonment, and dependency Cognition and aging Cognition includes learning, memory, & intelligence Learning is the ability to gain new skills and information. It may be slower in elderly, especially verbal learning. Cognition and aging (continued) Memory is divided into immediate, short- and long- term memory. Immediate memory remains intact. Short-term memory is also intact, however, it is affected by concentration which may be less in older adults. Long-term memory is most affected by aging. Retrieval is less efficient; the elderly need more cues Intelligence Ability to use information in an adaptive way or to apply knowledge to specific circumstances Crystallized intelligence includes vocabulary, verbal skills, and general information can continue to increase throughout life. Fluid intelligence consist