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Depression and Dementia Alzheimer S In the ElderlyTerm Paper

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¶ … health issues present themselves during the elder years of any patient, there is a lot of attention paid to cognitive and mood issues in this age group. The disorders and maladies that are applicable when speaking of this subject include, among others, depression, dementia, mild cognitive impairment (MCI) and milder cases of Alzheimer's. Just as they could and should be handled and addressed for younger age groups, they should also be addressed for the elderly. This report shall endeavor to answer a series of questions relevant to the above including the demarcation between individual results and group trends, the ethics of diagnosing patients properly, the proper administration of tests, how to interpret the results of those tests and a few other important topics.


The author of this report is offering a term paper relating to cognitive and depression issues with the elderly populations of the United States and the broader world. These disorders and maladies include dementia, depression and milder cases of Alzheimer's. The sections that will be included and well-covered in this report include a clear introduction, a discussion of the relevant subtopics, a review of the literature and an integration with the course text and materials. While depression and memory-related disorders are not entirely pervasive among the elderly population, they are certainly prominent enough so as to present some major challenges to both the patients as well as their providers and family members and thus there needs to be an in-depth review of the implications and facts as they exist and are currently known.

Preliminary Discussion

Regardless of the age of a given patient or person, the need for cognitive assessment often arises when it is clear that there is some sort of discord and problem with a person's mood, memory, emotions and so forth (Brown, 2014). For example, if an elderly person is all of a sudden sullen, extremely quiet and otherwise withdrawn, especially as compared to how they normally have been in recent weeks and months, this should be a cause for concern (Brown, 2014). Another example would be a person in their sixties or seventies that has been very sharp and on top of their daily affairs and they all of a sudden start forgetting very basic and obvious things like paying the credit card or phone bills (Brown, 2014). In short, when there is an obvious mental problem of any sort and/or there is a sharp departure from a person's normal behavior and mindset, this should precipitate a check of the person's cognitive faculties and abilities (Brown, 2014). Even better, there could also be a comparison to what has been measured and observed on prior occasions so that there is a reference point to draw against (Brown, 2014). Regardless, if it is clear that there is a depression-related or cognitive impairment such as dementia or even Alzheimer's, the protocol and norms for how that patient should be dealt with will obviously change. It could be as simple as therapy or pharmacology when it comes to depression (Long et al., 2015). When it comes to dementia and Alzheimer's, there is obviously going to be a focus on getting the patient into a care situation where they are safe and unable to hurt themselves, hurt others through negligence or go missing due to losing their bearings and point of reference (Brown, 2014).

Study Questions

What do you perceive are the primary strengths and limitations of cognitive assessment for the elderly?

How do you see a strong clinician balancing the tension between idiographic (individual) and nomothetic (generalized) perspectives on cognitive assessment?

In other words, how does the clinician effectively assess the individual while at the same time situating the individual within the larger understanding of human intelligence and achievement?

What are your opinions of clinicians making inferences about real-life performances form tests performed in a "test-taking" situation?

How credible do you believe this data is in evaluating a person's functioning?

What are some prominent ethical issues to consider in the evaluation of the individual?

The next two sections of this report are obviously the most important, those being the literature review and the discussion. The questions noted above will be answered as part of the discussion but only after the literature review is done in full. Indeed, the full literature review should be done so as to inform the answers that the author of this report comes to for the questions. The answers given will be from a combination of the literature review itself and the informed perspective of the author of this report.

Literature Review

The author of this report wishes to deeply study the cognitive and mood impairments mentioned above as they exist in the elderly. With that in mind, a thorough review of the scholarly literature will inform the author about the answers to come later in this report. One tactic that can be used to combat odd and incomplete results is the use of reexamination, reconceptualization and practical application of the data in question (Ridley, Li & Hill, 1998). This is but one way to ensure that any psychological assessment is as accurate, impartial and thorough as possible. Part and parcel of doing the assessments the right way is to ensure that the counselor or other clinician completing the test is qualified and adept at giving said test. As stated by Ridley, "this assertion, of course, rests on an incontrovertible presupposition: that clinicians are competent, especially in using reliable assessment procedures (Ridley, Li & Hill, 1998, p. 827). The assertion that Ridley et al. references is that "psychological assessment should be accurate, thorough and impartial (Ridley, Li & Hill, 1998, p. 827). This is further revealed to be important when taking into account that society and culture further muddy the waters when it comes to deciphering and interpreting what a patient is trying to say and project (Ridley, Li & Hill, 1998).

One of the questions posed for this report focuses on intelligence. Building on the mention of culture and society covered in the prior paragraph, one has to understand that intelligence and knowledge have to be considered given the context of the culture and society that a person inhabits (Aklin & Turner, 2006). The full picture of intelligence is what a person knows and the cultural traits that feed and influence that knowledge and intelligence (Sternberg, 2004). Further, as society has changed, the aggregate IQ scores of the people within these societies has risen as well. This has been verified in multiple studies done by Flynn and others ranging from at least the 1980's to within the last decade. While technology and educational advances are seen as contributory to this increase in intelligence, the uniformity of the rise across all cultures and peoples cannot be explained by that alone. This has come to be known as the Flynn effect and would obviously have a bearing on what needs to happen with patients as they enter their elder years (Sternberg, 2010; McGrew, 2010).

When it comes to measuring things like cognitive impairment in the elderly, the number of instruments and how they are applied actually varies quite a bit. Indeed, there are about twenty brief cognitive instruments that are used for reasons such as efficacy, ease of administration and familiarity with the instrument (Velayudhan et al., 2014). Even with the litany of examinations and tests that exist, some methods have more staying power than others. For example, the mental status examination (MSE) has been around for half a century and is heavily used in psychiatry, clinical psychology and general social work (Polanski & Hinkle, 2000). At the same time, some realms and areas of mental health and cognitive disorders in general are less than settled. Just one example of this is the subject of what is known as Mild Cognitive Impairment (MCI). As recently as 2005, it was asserted that "MCI as an entity is evolving and somewhat controversial (Nasreddine et al., 2005, pp. 695). Beyond that, some people with MCI actually regain some of their cognitive function, which goes against the dementia/Alzheimer's grain that most people and clinicians tend to see and expect (Kang et al., 2014). Even with that being the case, it will be very important to find as much clarity and settle science/medicine as possible given that there will be 600 million of the world's population will be elderly (over the age of 65) by the year 2020, which is a scant five years from now (Morais, Rodrigues & Sousa, 2009). The efficacy and applicability of tests comes through things like validation. In other words, this would be proof that the test accurately measures what it proclaims to and intends to measure (Kaya et al., 2014).


Question One

When it comes to the primary strengths and weaknesses when it comes to assessing the elderly, a strength would be the fact that the dimensions and definitions of the disorders in questions are fairly basic. Indeed, even if the patient is not completely participatory in the process… [END OF PREVIEW]

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