Geriatric Psychiatry Quiz

Cortical atrophy refers to the shrinking or loss of brain cells in the cerebral cortex, which is the outer layer of the brain responsible for higher cognitive functions. This is a normal part of the aging process and is associated with a decline in cognitive abilities. As the cortex shrinks, there is a reduction in the size and number of neurons, leading to a decrease in brain volume. This can result in changes in memory, attention, and other cognitive functions.

The given correct answer states that severity is predictive of poor prognosis in late-life depression. This means that the more severe the depression is, the worse the outcome or prognosis is likely to be. In other words, individuals with more severe late-life depression may have a more difficult time recovering or achieving remission compared to those with milder forms of depression. This suggests that severity plays a significant role in determining the overall prognosis and treatment outcomes for late-life depression.

An elderly patient with a history of alcohol abuse is at an increased risk of both depression and dementia. Alcohol abuse can have detrimental effects on the brain, leading to cognitive decline and memory problems, which are symptoms of dementia. Additionally, alcohol abuse is often associated with mental health issues such as depression. Therefore, it is likely that an elderly patient with a history of alcohol abuse would be at an increased risk of both depression and dementia.

The statement "Multiple episodes predict a poor prognosis" means that individuals who experience multiple episodes of late-life depression are more likely to have a worse outcome or prognosis compared to those who have only one episode. This suggests that recurrent or chronic depression in older adults may be more difficult to treat and may have a more negative impact on their overall well-being and functioning. This information highlights the importance of early detection and intervention for individuals with late-life depression to prevent the development of multiple episodes and improve their prognosis.

With normal aging, there is a natural decline in muscle mass. This is known as sarcopenia, and it is a result of various factors such as hormonal changes, decreased physical activity, and poor nutrition. As individuals age, they tend to lose muscle tissue and experience a decrease in muscle strength and function. This can lead to a decrease in overall mobility and an increased risk of falls and fractures. Therefore, the decrease in muscle mass is a common change that occurs with normal aging.

Suicide in the elderly is more frequently lethal compared to other age groups. This means that a higher proportion of elderly individuals who attempt suicide are successful in their attempts, leading to a higher mortality rate. This could be due to factors such as the use of more lethal methods or a higher prevalence of serious health conditions in the elderly population.

As people age, their motor response time tends to slow down. This means that it takes longer for them to react and respond to stimuli or perform physical tasks. This can be observed in activities such as driving, where older individuals may have slower reaction times compared to younger individuals. This decline in motor response speed is a normal part of the aging process and is attributed to changes in the nervous system and muscle function.

not-available-via-ai

As individuals age, their brains undergo various changes. One of these changes is ventricular enlargement, which refers to an increase in the size of the fluid-filled spaces in the brain called ventricles. This enlargement is a common finding in elderly individuals and is associated with the aging process. It is believed to be a result of the loss of brain tissue and the shrinking of certain brain regions. Ventricular enlargement can be seen on brain imaging studies and is considered a normal part of aging, although it can also be associated with certain neurological conditions.

Sexual activity in the elderly is not associated with socio-economic level. This means that regardless of a person's financial status or social standing, their likelihood of engaging in sexual activity does not depend on these factors. Other factors such as degree of health, partner availability, and previous sexual activity partners may influence sexual activity in the elderly, but not socio-economic level.

Geriatric psychopharmacology refers to the study of how drugs are metabolized in elderly individuals. One characteristic of drug metabolism in the elderly is a decreased rate of hepatic oxidation. This means that the liver, which is responsible for metabolizing drugs, becomes less efficient in breaking down drugs through oxidation. This can result in drugs staying in the system for longer periods of time, potentially leading to increased drug effects and a higher risk of drug interactions.

As individuals age, there is a decline in liver function and metabolism. This can result in a decrease in liver enzymes, rather than an increase. Liver enzymes are responsible for metabolizing drugs, and their decline can lead to a decrease in drug metabolism and clearance. Therefore, the statement "Increased liver enzymes" is not seen in the pharmacokinetics of aging.

Psychotherapy and antidepressant is the best treatment for post-menopausal women because it addresses both the psychological and physical symptoms that women may experience during this stage. Psychotherapy helps individuals cope with emotional changes and provides support, while antidepressants can help alleviate symptoms such as mood swings, anxiety, and depression. Estrogen replacement therapy may be beneficial for some women, but it is not always recommended due to potential risks. Progesterone may be used in combination with estrogen, but it is not the primary treatment for post-menopausal symptoms.

As individuals age, there are several pharmacokinetic changes that can occur, including changes in absorption, distribution, metabolism, and protein binding. However, absorption is the pharmacokinetic change that has the least effect on drug therapy in the elderly. This is because absorption primarily depends on the drug's formulation and route of administration, rather than age-related changes in the body. Therefore, even though there may be changes in the gastrointestinal tract and blood flow with aging, these changes have minimal impact on drug absorption in comparison to the other pharmacokinetic changes.

The given statement that patients who have their first onset of depression after the age of 60 are less likely to experience a recurrence is FALSE. Recurrence rates for depression do not vary based on the age of onset. Depression can recur at any age, including after the age of 60.

As individuals age, it is common to see a decrease in slow wave sleep. Slow wave sleep, also known as deep sleep, is important for physical restoration and rejuvenation. It is characterized by slow brain waves and is associated with memory consolidation and overall cognitive function. The decrease in slow wave sleep in the elderly is believed to be due to age-related changes in the brain and the natural aging process. This decrease in slow wave sleep can contribute to sleep disturbances and may lead to daytime sleepiness and cognitive decline in older adults.

Anxiety disorders are the most common psychiatric disorder after age 65. This is because older adults often face significant life changes and challenges such as retirement, loss of loved ones, and declining health, which can lead to increased levels of anxiety. Additionally, older adults may also have underlying medical conditions that can contribute to anxiety symptoms. Therefore, it is not surprising that anxiety disorders are more prevalent in this age group compared to mood disorders, severe cognitive impairment, or alcohol abuse.

Nortriptyline is the most preferable tricyclic antidepressant in the elderly because it has a lower risk of side effects compared to other tricyclic antidepressants. It has a longer half-life, which allows for once-daily dosing, making it easier for elderly patients to adhere to their medication regimen. Additionally, nortriptyline has a lower anticholinergic burden, reducing the risk of cognitive impairment and other adverse effects commonly seen in the elderly population.

Financial abuse is the most common form of elder abuse because it involves the unauthorized or improper use of an elderly person's financial resources. This can include stealing money or possessions, coercing the elderly person into giving away their assets, or fraudulently manipulating their finances. Financial abuse can have devastating consequences for the elderly person, leading to financial instability, loss of independence, and even homelessness. It is important to raise awareness about this form of abuse and take steps to prevent and address it.

As people age, their immune system weakens, leading to a decrease in the body's ability to fight off infections and diseases. This weakened immune response can result in less pronounced signs of illnesses such as pain or fever. Additionally, the body tends to lose muscle mass and gain fat as it ages, leading to a decrease in overall body fat. However, vital capacity, which is the maximum amount of air a person can exhale after taking a deep breath, tends to decrease with age due to changes in lung function. Therefore, the correct answer is less pronounced signs of illnesses such as pain or fever.