Disorders in Older People Alzheimer's and Eating Disorders and how they affect Older Adults

Alzheimer's and Eating Disorders and how they affect Older Adults

Disorders in Older People

Alzheimer's-Type Dementia

Eating Disorders

Disorders in Older People

In considering the general health of the population, the larger elderly population does not necessarily imply that most of them live or are ill from severe disabilities. Age related disorders would occur to different people early or late in their lives. People are living longer and healthier, with the elderly population achieving this in the higher age range of 5-10 years population cohort. However, there are key exceptions in the perspective of disorders and mental disorders in the older population. These are indicated by disorders like dementia, Alzheimer's and a wider spectrum of the disease and related disorders. Understanding the problem of mental disorders in older people is currently an area of interest. In this study, a thorough review of literature is carried out to elicit data on two disorders affecting the elderly population.

The interest is on understanding Delirium, Dementia, Amnesic and other Cognition Disorders and eating disorders, categories from the Diagnostic and Statistical Manual of Mental Orders (DSM-IV-TR) in older people. The cognition includes orientation, language, judgment, memory, and performance of actions, problem solving, and conducting of interpersonal relationships (Benjamin & Virginia, 2008). Cognitive disorders are those that disrupt in one way or another these aspects and are complicated by symptoms in behavior. Delirium, Dementia, Amnesic and other Cognition Disorders, are exemplified by complex interfaces between psychiatry, medicine, and neurology.

According to the DSM-IV-TR category, the three groups, dementia, delirium, and amnestic disorders are characterized by symptoms common to all disorders. This is impairment to the cognition, where Delirium is short-term confusion indicated by changes in cognition. The causes of delirium are general medical conditions like infection, multiple causes like kidney and head trauma, not specified delirium, and substance induced delirium (Benjamin & Virginia, 2008). Dementia is indicated by severe impairment in judgment, memory, cognition, and orientation. There are six categories of dementia including Alzheimer's type dementia, occurring mainly in persons over 65 years and indicated by delusions, dementia, disorientation, and depression. This also includes vascular dementia by thrombosis or hemorrhage in vessels, medical conditions like head trauma, pick's disease, substance induced, multiple etiologies, and otherwise specified (Benjamin & Virginia, 2008). Amnestic disorder is indicated by forgetfulness and memory impairment, caused by medical condition or hypoxia, medication or toxin induced. Of interest is the presentation of Dementia in the elderly population, especially the Alzheimer type dementia. This is because Dementia is indicated by symptoms common to other disorders in the DSM-IV-TR category, indicated by impaired judgment, memory, cognition, and speech orientation as seen in the review of literature.

While many studies investigate cognitive disorders in the elderly population, few studies investigate the trend of eating disorders in this population. This is because eating disorders are considered disorders among adolescents and middle age people. Eating disorders are investigated in this research for they are on the rise among the elderly population (Business Wire, 2013). Eating disorders are indicated by two conditions, Bulimia Nervosa and Anorexia Nervosa, which are both characterized by an emphasis of body image. The review of literature indicates that eating disorders in the elderly develops have symptoms similar to those in younger sufferers, with a greater emphasis on body image. This research investigates eating disorders as a mental disorder affecting the elderly from issues like difficulty eating, dementia or forgetting to eat, cancer or illness related inability to cook and shop, poverty, elderly abuse and isolation.

Review of Literature

Alzheimer's-Type Dementia

More than 70 diseases and conditions can cause Dementia. Though rare, temporal dementia can be caused by substance abuse, urinary tract infection, or vitamin deficiency. Alzheimer's disease is the most common type of dementia, present in 70% cases of dementia (Sullivan & Sullivan, 2010). Fraller (2013) states that it is more than 100 years since Alois Alzheimer published the case study of his patient, Auguste, a woman 51-year-old who displayed symptoms of "irrationality, memory loss, disorientation to time and place, paranoia, hallucinations, and difficulties with language and cognition." These symptoms all progressed to incontinence, being bedridden and nonverbal. Following the patient's death an autopsy showed " Atrophy, tangled bundles of neurofibrils and accumulations of an unknown substance in a miliary pattern" (Fraller, 2013, p.63). The combination of "memory loss, loss of executive function, behavioral symptoms, and patterns of histopathological lesions" is what...

(Strassnig & Ganguli, 2005). There are three stages of Alzheimer's including moderate, mild, or early stage, and late or severe stage. The advancement of the disease from one stage to another is indicated by a progression and seriousness of symptoms.
Studies identify that Alzheimer's is not a normal aging disease, often afflicting elderly persons 65 years and older. According to Fairfield and Mammarella (2009), the results of individual longevity and population growth indicate that there are many elderly persons with Alzheimer's accelerator gene, proposed by Roses Allen. The study finds that persons will Alzheimer's type dementia indicate source-monitoring deficits. According to the source-monitoring deficit theory, people use two classes of information in discriminating memory origins. These include qualitative characteristics like contextual detail with associated cognitive operations, and conceptual type of information like general knowledge. Persons with Alzheimer's disease have diminished capacity in using either category of information to discriminate memory. To prove the deficit of this theory in elderly Alzheimer's patients, the research examined cognitive operations between internally and externally generated events in pathological and healthy aging persons. Fairfield and Mammarella (2009) results indicate the older adults have difficulty that younger adults in discriminating between memories in performed and imagined performing. The study also found that elderly patients with Alzheimer's type dementia had marked difficulties in attributing the sources of imagined actions.

Carreiras, Baquero, and Rodriguez (2008) investigated syllable congruency frequency effect and syllable congruency effect in Alzheimer patients, young adults, and elderly persons presented similar results to Fairfield and Mammarella (2009). The results of the study indicate that syllable congruency effects existed, but were different in the three test groups (Carreiras, Baquero, & Rodriguez, 2008). The syllable congruency response in young adults is higher than in elderly and Alzheimer patients. Young adults responded more slowly to high frequency syllables and highly to low frequency syllables, while the elderly and Alzheimer patients responded slowly to low frequency syllables and highly to high frequency syllables. This is an indication of cognition impairment that affects speech orientation.

The findings of this research are in agreement with the report by Nursing Home & Elder Business Week (2012) which identifies that Alzheimer's disease is defined by memory problems. The study's intention was to produce results that could create insight into the development of intervention measures for prevention and causes of symptoms of Alzheimer's disease. The research studies 658 adults of age 65 and above, free from dementia. The study group was given MRI scans, tests to measure language, memory, speed of processing information and visual perception (Nursing Home & Elder Business Week, 2012). By the end of the study, 174 had silent strokes. The result indicated that people with silent strokes scored slightly lower in memory tests than those without silent strokes. The results were also indicated in persons with small hippocampus, the memory center of the brain. The study linked the fact that Alzheimer's is associated with memory problems and linked this with the noted memory problems in persons with silent strokes and small hippocampus.

The location of the cause to impaired cognitive and memory loss is associated with the brain function. This review further finds Alzheimer's because of the impairment in the brain from the study by Strassnig & Ganguli, 2005 cited in: Fraller (2013). In (Strassnig & Ganguli, 2005 cited in: Fraller, 2013, p.63) The Fraller (2013) reports that the Alzheimer's Disease Neuroimaging Initiative (ADNI) is an "…ongoing longitudinal international research collaboration funded by the National Institute of Aging (NIA), multiple pharmaceutical companies and private donations via the Foundation for the National Institutes of Health (NIH)" (p.64). This project resulted in the development of "new biomarkers and brain imaging techniques" which enable the ability to see AD pathology in a patient while they are still alive. These techniques in combination with patient history and cognitive testing are such that may well serve to bring about improvement in "certainty of the diagnosis of AD and enable diagnosis of AD earlier in the disease process." (Fraller, 2013, p.64) There would be many benefits. Over the past five years research has indicated that there may be benefits on patient's cognition who have AD using vitamins E, B12, B6, folic acid; omega 3 in fish oil; and ibuprofen.

These studies indicate the role of assessment and management of Alzheimer's disease. In Fraller (2013), management entails the use of using vitamins E, B12, B6, folic acid; omega 3 in fish oil; and ibuprofen (p.64). This also involves the improvement of Alzheimer patient's speech using light and physical therapy. In the management of Alzheimer's disease, the approved treatment includes Donepezil, rivastigmine, galantamine and tacrine in mild-to-moderate…