Kathleen V. Wilkes
- Published in print:
- 1993
- Published Online:
- October 2011
- ISBN:
- 9780198240808
- eISBN:
- 9780191680281
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198240808.001.0001
- Subject:
- Philosophy, Philosophy of Mind, Metaphysics/Epistemology
This book explores the scope and limits of the concept of a person — a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing ...
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This book explores the scope and limits of the concept of a person — a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity and dementia, dissociated states, and split brains. The popular faith in continuity of consciousness and the unity of the person is subjected to sustained criticism. The author concludes with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science.Less
This book explores the scope and limits of the concept of a person — a vexed question in contemporary philosophy. The author begins by questioning the methodology of thought-experimentation, arguing that it engenders inconclusive and unconvincing results, and that truth is stranger than fiction. She then examines an assortment of real-life conditions, including infancy, insanity and dementia, dissociated states, and split brains. The popular faith in continuity of consciousness and the unity of the person is subjected to sustained criticism. The author concludes with a look at different views of the person found in Homer, Aristotle, the post-Cartesians, and contemporary cognitive science.
Margaret Lock
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691149783
- eISBN:
- 9781400848461
- Item type:
- book
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691149783.001.0001
- Subject:
- Anthropology, Social and Cultural Anthropology
Due to rapidly aging populations, the number of people worldwide experiencing dementia is increasing, and the projections are grim. Despite billions of dollars invested in medical research, no ...
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Due to rapidly aging populations, the number of people worldwide experiencing dementia is increasing, and the projections are grim. Despite billions of dollars invested in medical research, no effective treatment has been discovered for Alzheimer's disease, the most common form of dementia. This book exposes the predicaments embedded in current efforts to slow down or halt Alzheimer's disease through early detection of pre-symptomatic biological changes in healthy individuals. Based on a meticulous account of the history of Alzheimer's disease and extensive in-depth interviews, the book highlights the limitations and the dissent associated with biomarker detection. It argues that basic research must continue, but should be complemented by a public health approach to prevention that is economically feasible, more humane, and much more effective globally than one exclusively focused on an increasingly harried search for a cure.Less
Due to rapidly aging populations, the number of people worldwide experiencing dementia is increasing, and the projections are grim. Despite billions of dollars invested in medical research, no effective treatment has been discovered for Alzheimer's disease, the most common form of dementia. This book exposes the predicaments embedded in current efforts to slow down or halt Alzheimer's disease through early detection of pre-symptomatic biological changes in healthy individuals. Based on a meticulous account of the history of Alzheimer's disease and extensive in-depth interviews, the book highlights the limitations and the dissent associated with biomarker detection. It argues that basic research must continue, but should be complemented by a public health approach to prevention that is economically feasible, more humane, and much more effective globally than one exclusively focused on an increasingly harried search for a cure.
António J. Bastos-Leite and Philip Scheltens
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195328875
- eISBN:
- 9780199864836
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195328875.003.0016
- Subject:
- Neuroscience, Techniques, Development
Magnetic resonance imaging (MRI) has opened up the way to diagnose dementia in vivo. It provides clear evidence for hippocampal atrophy in Alzheimer's disease (AD), lobar atrophy in frontotemporal ...
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Magnetic resonance imaging (MRI) has opened up the way to diagnose dementia in vivo. It provides clear evidence for hippocampal atrophy in Alzheimer's disease (AD), lobar atrophy in frontotemporal lobar degeneration (FTLD), vascular changes in VaD, and specific findings in some rare forms of dementia. In addition, the traditional role of excluding space-occupying lesions has been kept and the combination of both aspects has rendered MRI indispensable in the diagnostic work-up.Less
Magnetic resonance imaging (MRI) has opened up the way to diagnose dementia in vivo. It provides clear evidence for hippocampal atrophy in Alzheimer's disease (AD), lobar atrophy in frontotemporal lobar degeneration (FTLD), vascular changes in VaD, and specific findings in some rare forms of dementia. In addition, the traditional role of excluding space-occupying lesions has been kept and the combination of both aspects has rendered MRI indispensable in the diagnostic work-up.
Margaret Lock
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691149783
- eISBN:
- 9781400848461
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691149783.003.0002
- Subject:
- Anthropology, Social and Cultural Anthropology
This chapter focuses on the “discovery” of Alzheimer disease (AD) and a somewhat condensed genealogy of its history to the present time. Emphasis is given to the virtual disappearance of AD for over ...
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This chapter focuses on the “discovery” of Alzheimer disease (AD) and a somewhat condensed genealogy of its history to the present time. Emphasis is given to the virtual disappearance of AD for over four decades after its initial identification, followed by its rediscovery in the late 1960s in association with government and medical recognition of aging populations and their impending burden on society. The chapter also discusses the consolidation of what has been the dominant research paradigm in AD research for the past four decades-the amyloid cascade hypothesis, grounded in localization theory. Throughout the study, difficulties in attempting to unravel the entanglement of “normal” aging from dementia, evident from Alois Alzheimer's time, are pointed out.Less
This chapter focuses on the “discovery” of Alzheimer disease (AD) and a somewhat condensed genealogy of its history to the present time. Emphasis is given to the virtual disappearance of AD for over four decades after its initial identification, followed by its rediscovery in the late 1960s in association with government and medical recognition of aging populations and their impending burden on society. The chapter also discusses the consolidation of what has been the dominant research paradigm in AD research for the past four decades-the amyloid cascade hypothesis, grounded in localization theory. Throughout the study, difficulties in attempting to unravel the entanglement of “normal” aging from dementia, evident from Alois Alzheimer's time, are pointed out.
Margaret Lock
- Published in print:
- 2013
- Published Online:
- October 2017
- ISBN:
- 9780691149783
- eISBN:
- 9781400848461
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691149783.003.0011
- Subject:
- Anthropology, Social and Cultural Anthropology
This concluding chapter presents emerging knowledge in both epigenetics and epidemiology, suggesting that forms of prevention that take a public health approach, including lifestyle changes, reduced ...
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This concluding chapter presents emerging knowledge in both epigenetics and epidemiology, suggesting that forms of prevention that take a public health approach, including lifestyle changes, reduced exposure to toxins, reductions in poverty, increased community support, and other variables, is likely to reduce the prevalence of dementia worldwide to a much greater extent than would an approach confined to expensive molecular micro-medical management of segments of those populations deemed to be at risk that happen to be located in wealthier countries. Furthermore, a molecular approach to Alzheimer disease prevention requires healthy individuals, some as young as 18 years of age, to become research subjects on whom repeated tests will be carried out.Less
This concluding chapter presents emerging knowledge in both epigenetics and epidemiology, suggesting that forms of prevention that take a public health approach, including lifestyle changes, reduced exposure to toxins, reductions in poverty, increased community support, and other variables, is likely to reduce the prevalence of dementia worldwide to a much greater extent than would an approach confined to expensive molecular micro-medical management of segments of those populations deemed to be at risk that happen to be located in wealthier countries. Furthermore, a molecular approach to Alzheimer disease prevention requires healthy individuals, some as young as 18 years of age, to become research subjects on whom repeated tests will be carried out.
William Jagust and Mark D'Esposito (eds)
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195328875
- eISBN:
- 9780199864836
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195328875.001.0001
- Subject:
- Neuroscience, Techniques, Development
The study of brain aging has been revolutionized through advances in molecular neuroscience, cognitive neuroscience, and brain imaging. The application of new concepts and techniques has permitted ...
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The study of brain aging has been revolutionized through advances in molecular neuroscience, cognitive neuroscience, and brain imaging. The application of new concepts and techniques has permitted investigators to explore the changes in structure, function, and biochemistry in living humans in order to unravel mechanisms that underlie both age-related cognitive decline and preservation of cognition into old age. This book reviews both the basic science and clinical applications of brain imaging in the study of brain aging. Topics reviewed include technical issues associated with imaging studies in older brains, pathology of brain aging, structural changes in the aging brain, changes in dopamine function, and mechanisms of brain reserve and plasticity. The use of genetics in combination with brain imaging and the use of animal models are also explored. Clinical applications include the diagnosis and prediction of cognitive decline using a variety of different imaging approaches as well as a detailed description of amyloid imaging using PET scanning. Other topics include functional MRI studies in aging, the use of imaging in therapeutic monitoring and drug development, and the role of large-scale databases. The volume contains information both for those involved in brain imaging research and for those new to the field who are in need of a systematic overview.Less
The study of brain aging has been revolutionized through advances in molecular neuroscience, cognitive neuroscience, and brain imaging. The application of new concepts and techniques has permitted investigators to explore the changes in structure, function, and biochemistry in living humans in order to unravel mechanisms that underlie both age-related cognitive decline and preservation of cognition into old age. This book reviews both the basic science and clinical applications of brain imaging in the study of brain aging. Topics reviewed include technical issues associated with imaging studies in older brains, pathology of brain aging, structural changes in the aging brain, changes in dopamine function, and mechanisms of brain reserve and plasticity. The use of genetics in combination with brain imaging and the use of animal models are also explored. Clinical applications include the diagnosis and prediction of cognitive decline using a variety of different imaging approaches as well as a detailed description of amyloid imaging using PET scanning. Other topics include functional MRI studies in aging, the use of imaging in therapeutic monitoring and drug development, and the role of large-scale databases. The volume contains information both for those involved in brain imaging research and for those new to the field who are in need of a systematic overview.
Julia Addington-Hall and Irene Higginson (eds)
- Published in print:
- 2001
- Published Online:
- November 2011
- ISBN:
- 9780192629609
- eISBN:
- 9780191730054
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192629609.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
The specialty of palliative care has traditionally grown out of oncology and there has been little research into the needs of patients dying from causes other than cancer. Few non-cancer patients ...
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The specialty of palliative care has traditionally grown out of oncology and there has been little research into the needs of patients dying from causes other than cancer. Few non-cancer patients receive hospice in-patient, home care, or day care although a good proportion of hospices say that their services are available to non-cancer patients. As a result, the importance of palliative care for non-cancer patients is now being increasingly recognized internationally, and in the UK a committee reporting to the Department of Health recommended that palliative care should be accessible to all patients who need such care. This book considers the needs and experiences of patients dying from, for example, stroke, heart disease, or dementia by drawing on a range of disciplines and specialties in medicine. The provision of palliative care for patients dying from causes other than cancer raises a number of important questions for policy makers and purchasers. This book summarizes what is known about the needs of and appropriate service provision for people dying of causes other than cancer and begins to set a research agenda.Less
The specialty of palliative care has traditionally grown out of oncology and there has been little research into the needs of patients dying from causes other than cancer. Few non-cancer patients receive hospice in-patient, home care, or day care although a good proportion of hospices say that their services are available to non-cancer patients. As a result, the importance of palliative care for non-cancer patients is now being increasingly recognized internationally, and in the UK a committee reporting to the Department of Health recommended that palliative care should be accessible to all patients who need such care. This book considers the needs and experiences of patients dying from, for example, stroke, heart disease, or dementia by drawing on a range of disciplines and specialties in medicine. The provision of palliative care for patients dying from causes other than cancer raises a number of important questions for policy makers and purchasers. This book summarizes what is known about the needs of and appropriate service provision for people dying of causes other than cancer and begins to set a research agenda.
Jay A. Liveson and Dong M. Ma
- Published in print:
- 1999
- Published Online:
- March 2012
- ISBN:
- 9780195129243
- eISBN:
- 9780199847792
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195129243.003.0016
- Subject:
- Neuroscience, Techniques
P300 potentials are slow waves that depend on stimuli containing information that the subject must process. The types of stimuli are independent of the sensory modality of the stimuli, and have ...
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P300 potentials are slow waves that depend on stimuli containing information that the subject must process. The types of stimuli are independent of the sensory modality of the stimuli, and have included auditory, visual, and tactile, among others. The function of these potentials is controversial, but it best correlates with evaluation time when unpredictable events have to be discriminated. At present, these studies can be helpful in distinguishing organic dementia (such as in Alzheimer's disease) from the pseudodementia associated with depression. P300 potentials can be used to evaluate drugs. In addition, abnormalities have been found in schizophrenics, alcoholics and their families, and patients with chronic renal failure. A pre-recorded sequence of intermixed tones is presented in two manners. At first, the subject is instructed to ignore the tone (“ignore” condition). Secondly, the subject is instructed to distinguish the tones (“attend” condition). The desired response occurs only in the latter condition.Less
P300 potentials are slow waves that depend on stimuli containing information that the subject must process. The types of stimuli are independent of the sensory modality of the stimuli, and have included auditory, visual, and tactile, among others. The function of these potentials is controversial, but it best correlates with evaluation time when unpredictable events have to be discriminated. At present, these studies can be helpful in distinguishing organic dementia (such as in Alzheimer's disease) from the pseudodementia associated with depression. P300 potentials can be used to evaluate drugs. In addition, abnormalities have been found in schizophrenics, alcoholics and their families, and patients with chronic renal failure. A pre-recorded sequence of intermixed tones is presented in two manners. At first, the subject is instructed to ignore the tone (“ignore” condition). Secondly, the subject is instructed to distinguish the tones (“attend” condition). The desired response occurs only in the latter condition.
K. Warner Schaie
- Published in print:
- 2005
- Published Online:
- September 2007
- ISBN:
- 9780195156737
- eISBN:
- 9780199786817
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195156737.001.0001
- Subject:
- Psychology, Developmental Psychology
This book lays out the reasons why we should study cognitive development in adulthood, and presents the history, latest data, and results from the Seattle Longitudinal Study (SLS), which now extends ...
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This book lays out the reasons why we should study cognitive development in adulthood, and presents the history, latest data, and results from the Seattle Longitudinal Study (SLS), which now extends to over forty-five years. The SLS is organized around five questions: does intelligence change uniformly throughout adulthood, or are there different life-course-ability patterns? At what age and at what magnitude can decrement in ability be reliably detected? What are the patterns and magnitude of generational differences? What accounts for individual differences in age-related change in adulthood? Can the intellectual decline that increases with age be reversed by educational intervention? Based on work on the SLS, this book presents a conceptual model. The model represents this book's author's view on the factors that influence cognitive development throughout the human lifespan, and provides a rationale for the various influences that have been investigated — genetic factors, early and current family environment, life styles, the experience of chronic disease, and various personality attributes. The data in this volume include the 1998 longitudinal cycle of the SLS. In light of both new data and revised analyses, psychometric and neuropsychological assessments have been linked in long-term data to aid in the early identification of risk for dementia in later life. The book also presents new data and concludes on the impact of personality on cognition. It includes correlation matrices and web-access information for select data sets.Less
This book lays out the reasons why we should study cognitive development in adulthood, and presents the history, latest data, and results from the Seattle Longitudinal Study (SLS), which now extends to over forty-five years. The SLS is organized around five questions: does intelligence change uniformly throughout adulthood, or are there different life-course-ability patterns? At what age and at what magnitude can decrement in ability be reliably detected? What are the patterns and magnitude of generational differences? What accounts for individual differences in age-related change in adulthood? Can the intellectual decline that increases with age be reversed by educational intervention? Based on work on the SLS, this book presents a conceptual model. The model represents this book's author's view on the factors that influence cognitive development throughout the human lifespan, and provides a rationale for the various influences that have been investigated — genetic factors, early and current family environment, life styles, the experience of chronic disease, and various personality attributes. The data in this volume include the 1998 longitudinal cycle of the SLS. In light of both new data and revised analyses, psychometric and neuropsychological assessments have been linked in long-term data to aid in the early identification of risk for dementia in later life. The book also presents new data and concludes on the impact of personality on cognition. It includes correlation matrices and web-access information for select data sets.
K. Warner Schaie
- Published in print:
- 2005
- Published Online:
- September 2007
- ISBN:
- 9780195156737
- eISBN:
- 9780199786817
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195156737.003.0017
- Subject:
- Psychology, Developmental Psychology
Although the Seattle Longitudinal Study was designed to focus on cognitive changes in normal community-dwelling populations, it is inevitable that a prospective study of aging will eventually include ...
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Although the Seattle Longitudinal Study was designed to focus on cognitive changes in normal community-dwelling populations, it is inevitable that a prospective study of aging will eventually include in its successive follow-up cycles individuals who are beginning to show cognitive impairment and eventually may develop full-blown symptoms of dementia. This chapter reports some initial findings on the apolipoprotein E genetic marker of dementia as it relates to cognitive decline. Studies involving the neuropsychological assessment of a community-dwelling sample of older adults who have not previously been identified as suffering from cognitive impairment are described, along with the extension analyses that link the clinical measures with the psychometric battery for the study of normal aging. The chapter ends by analyzing studies that obtain postdicted estimates of earlier performance on the neuropsychological measures and speak to the possibility of early detection of risk for cognitive impairment.Less
Although the Seattle Longitudinal Study was designed to focus on cognitive changes in normal community-dwelling populations, it is inevitable that a prospective study of aging will eventually include in its successive follow-up cycles individuals who are beginning to show cognitive impairment and eventually may develop full-blown symptoms of dementia. This chapter reports some initial findings on the apolipoprotein E genetic marker of dementia as it relates to cognitive decline. Studies involving the neuropsychological assessment of a community-dwelling sample of older adults who have not previously been identified as suffering from cognitive impairment are described, along with the extension analyses that link the clinical measures with the psychometric battery for the study of normal aging. The chapter ends by analyzing studies that obtain postdicted estimates of earlier performance on the neuropsychological measures and speak to the possibility of early detection of risk for cognitive impairment.
Jean Matter Mandler
- Published in print:
- 2007
- Published Online:
- September 2007
- ISBN:
- 9780195311839
- eISBN:
- 9780199786770
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195311839.003.0009
- Subject:
- Psychology, Developmental Psychology
This chapter summarizes the large body of data on the initial organization of the conceptual system. The initial, and perhaps most important, conclusion that can be drawn from the data is that ...
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This chapter summarizes the large body of data on the initial organization of the conceptual system. The initial, and perhaps most important, conclusion that can be drawn from the data is that because the first concepts about objects are global in nature, the acquisition process tends to emphasize differentiation. The breakdown of the conceptual system in semantic dementia is discussed.Less
This chapter summarizes the large body of data on the initial organization of the conceptual system. The initial, and perhaps most important, conclusion that can be drawn from the data is that because the first concepts about objects are global in nature, the acquisition process tends to emphasize differentiation. The breakdown of the conceptual system in semantic dementia is discussed.
Jeffrey Kaye
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195328875
- eISBN:
- 9780199864836
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195328875.003.0010
- Subject:
- Neuroscience, Techniques, Development
The focus of this chapter is predicting cognitive decline or dementia in normal older people using structural imaging. Key questions addressed include the following: What are the major methods, both ...
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The focus of this chapter is predicting cognitive decline or dementia in normal older people using structural imaging. Key questions addressed include the following: What are the major methods, both clinical and imaging, that may help us to predict decline? What underlying pathologies do structural changes preceding decline suggest are developing in the brain? What is the evidence from structural studies that anatomical changes are present before behavioral ones or precede the diagnosis of mild cognitive impairment or dementia? Does imaging provide information about the pace of future decline? What are the limitations of these studies? Finally, what are the implications of structural imaging outcomes for application to the conduct of treatment studies and future research?Less
The focus of this chapter is predicting cognitive decline or dementia in normal older people using structural imaging. Key questions addressed include the following: What are the major methods, both clinical and imaging, that may help us to predict decline? What underlying pathologies do structural changes preceding decline suggest are developing in the brain? What is the evidence from structural studies that anatomical changes are present before behavioral ones or precede the diagnosis of mild cognitive impairment or dementia? Does imaging provide information about the pace of future decline? What are the limitations of these studies? Finally, what are the implications of structural imaging outcomes for application to the conduct of treatment studies and future research?
Eric Salmon, Fabienne Collette, and Gaëtan Garraux
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780195328875
- eISBN:
- 9780199864836
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195328875.003.0015
- Subject:
- Neuroscience, Techniques, Development
Functional neuroimaging in neurodegenerative dementias provides 3D representations of brain activity that are relatively characteristic of the underlying phenotypic distribution of cerebral lesions. ...
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Functional neuroimaging in neurodegenerative dementias provides 3D representations of brain activity that are relatively characteristic of the underlying phenotypic distribution of cerebral lesions. They are not specific for a given brain pathology and the heterogeneity of brain diseases must always be considered. However, when methodologies are optimized, the values for sensitivity, specificity, and early diagnostic accuracy approach 80%. A lot of studies have shown that Alzheimer's disease can be distinguished from depression, vascular dementia or frontotemporal dementia, and Lewy body dementia when two techniques are used. General recommendations are to rely on multiple key regions and to combine different neuroimaging techniques to make a differential diagnosis among dementias.Less
Functional neuroimaging in neurodegenerative dementias provides 3D representations of brain activity that are relatively characteristic of the underlying phenotypic distribution of cerebral lesions. They are not specific for a given brain pathology and the heterogeneity of brain diseases must always be considered. However, when methodologies are optimized, the values for sensitivity, specificity, and early diagnostic accuracy approach 80%. A lot of studies have shown that Alzheimer's disease can be distinguished from depression, vascular dementia or frontotemporal dementia, and Lewy body dementia when two techniques are used. General recommendations are to rely on multiple key regions and to combine different neuroimaging techniques to make a differential diagnosis among dementias.
Alisoun Milne
- Published in print:
- 2020
- Published Online:
- September 2020
- ISBN:
- 9781447305729
- eISBN:
- 9781447311904
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447305729.003.0009
- Subject:
- Sociology, Gerontology and Ageing
Chapters 8 & 9 focus on dementia. There is growing evidence of links between lifecourse inequalities and dementia. These are a mixture of structural issues such as poor education; mental health ...
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Chapters 8 & 9 focus on dementia. There is growing evidence of links between lifecourse inequalities and dementia. These are a mixture of structural issues such as poor education; mental health issues such as persistent mid-life depression; and physical conditions such as diabetes. Age related risk factors include social isolation and loneliness. These links reinforce the ‘accumulation of risks’ thesis and suggest that the causes of dementia are more complex and situated than is traditionally believed. In community-based populations, depression is estimated to affect about a fifth of people with Alzheimer's disease and a third of those with vascular dementia; up to half of care home residents with dementia have depression. Dementia produces high rates of anxiety symptoms particularly restlessness, agitation and fear; delirium is relatively common. The issues that protect quality of life of people with dementia are: psychological wellbeing, autonomy, having a meaningful role, acceptance, agency, promotion of selfhood and identity, relationships, financial security, and religious beliefs. Pre-dementia attributes such as personality type and how well a person adjusts to their diagnosis have a stronger influence on quality of life than having the condition per se. Most work capturing the perspectives of people living with dementia is done with those in the earlier stages.Less
Chapters 8 & 9 focus on dementia. There is growing evidence of links between lifecourse inequalities and dementia. These are a mixture of structural issues such as poor education; mental health issues such as persistent mid-life depression; and physical conditions such as diabetes. Age related risk factors include social isolation and loneliness. These links reinforce the ‘accumulation of risks’ thesis and suggest that the causes of dementia are more complex and situated than is traditionally believed. In community-based populations, depression is estimated to affect about a fifth of people with Alzheimer's disease and a third of those with vascular dementia; up to half of care home residents with dementia have depression. Dementia produces high rates of anxiety symptoms particularly restlessness, agitation and fear; delirium is relatively common. The issues that protect quality of life of people with dementia are: psychological wellbeing, autonomy, having a meaningful role, acceptance, agency, promotion of selfhood and identity, relationships, financial security, and religious beliefs. Pre-dementia attributes such as personality type and how well a person adjusts to their diagnosis have a stronger influence on quality of life than having the condition per se. Most work capturing the perspectives of people living with dementia is done with those in the earlier stages.
Alisoun Milne
- Published in print:
- 2020
- Published Online:
- September 2020
- ISBN:
- 9781447305729
- eISBN:
- 9781447311904
- Item type:
- chapter
- Publisher:
- Policy Press
- DOI:
- 10.1332/policypress/9781447305729.003.0010
- Subject:
- Sociology, Gerontology and Ageing
The way dementia is conceptualised influences the wellbeing and treatment of people living with the condition. The traditional neuro-degenerative model has increasingly been challenged. Significant ...
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The way dementia is conceptualised influences the wellbeing and treatment of people living with the condition. The traditional neuro-degenerative model has increasingly been challenged. Significant contributions include the 1970’s concepts of malignant social psychologv and personhood, the 1990’s drive to engage with the social model of disability, and the recent development of the social citizenship approach. Not only has this new paradigm widened the conceptual lens through which dementia is viewed but it has incorporated issues, beyond the biomedical, that extend our understanding of dementia as a situated condition and lived experience. It is situated in relationships, a lifecourse and a socio-political context and is shaped by inequalities and limited engagement with rights and social justice. Dementia is a multi-dimensional phenomenon and requires a response that addresses its clinical, psychological, social and political dimensions. The new paradigm helps re-focus policy, care and research on the person rather than the condition; relocates the ‘problem’ from the individual to societal structures, attitudes, policy and services; demands new forms of critical practice; and engages with the perspectives of people living with dementia. Whilst there are dementia specific policies in the UK they have limited legal traction and are not integrated with other relevant policies.Less
The way dementia is conceptualised influences the wellbeing and treatment of people living with the condition. The traditional neuro-degenerative model has increasingly been challenged. Significant contributions include the 1970’s concepts of malignant social psychologv and personhood, the 1990’s drive to engage with the social model of disability, and the recent development of the social citizenship approach. Not only has this new paradigm widened the conceptual lens through which dementia is viewed but it has incorporated issues, beyond the biomedical, that extend our understanding of dementia as a situated condition and lived experience. It is situated in relationships, a lifecourse and a socio-political context and is shaped by inequalities and limited engagement with rights and social justice. Dementia is a multi-dimensional phenomenon and requires a response that addresses its clinical, psychological, social and political dimensions. The new paradigm helps re-focus policy, care and research on the person rather than the condition; relocates the ‘problem’ from the individual to societal structures, attitudes, policy and services; demands new forms of critical practice; and engages with the perspectives of people living with dementia. Whilst there are dementia specific policies in the UK they have limited legal traction and are not integrated with other relevant policies.
Ellen M. Migo, Steve C.R. Williams, William R. Crum, Matthew J. Kempton, and Ulrich Ettinger
- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780195393804
- eISBN:
- 9780199863495
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195393804.003.0008
- Subject:
- Neuroscience, Disorders of the Nervous System
There is a clear need for biomarkers in neuro-degenerative and psychiatric disorders for both early and differential diagnosis, personalized prediction of treatment response, and in drug discovery. ...
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There is a clear need for biomarkers in neuro-degenerative and psychiatric disorders for both early and differential diagnosis, personalized prediction of treatment response, and in drug discovery. Non-invasive neuroimaging is a key area for biomarker development because it connects behavioural outcomes with structural, functional, and molecular mechanisms. This chapter discusses neuroimaging biomarkers in relation to dementia, schizophrenia, and mood disorders (bipolar and major depressive disorders). The current candidate biomarkers for each disorder are reviewed, across the full range of imaging modalities, followed by an evaluation of their future prospects. The chapter concludes that there has been substantial progress towards personalized neuroimaging-based biomarkers but much remains to be done. Such biomarkers must be validated for specific disorders and may include neuroimaging and non-neuroimaging components.Less
There is a clear need for biomarkers in neuro-degenerative and psychiatric disorders for both early and differential diagnosis, personalized prediction of treatment response, and in drug discovery. Non-invasive neuroimaging is a key area for biomarker development because it connects behavioural outcomes with structural, functional, and molecular mechanisms. This chapter discusses neuroimaging biomarkers in relation to dementia, schizophrenia, and mood disorders (bipolar and major depressive disorders). The current candidate biomarkers for each disorder are reviewed, across the full range of imaging modalities, followed by an evaluation of their future prospects. The chapter concludes that there has been substantial progress towards personalized neuroimaging-based biomarkers but much remains to be done. Such biomarkers must be validated for specific disorders and may include neuroimaging and non-neuroimaging components.
Renée L. Beard
- Published in print:
- 2016
- Published Online:
- January 2017
- ISBN:
- 9781479800117
- eISBN:
- 9781479855377
- Item type:
- book
- Publisher:
- NYU Press
- DOI:
- 10.18574/nyu/9781479800117.001.0001
- Subject:
- Social Work, Health and Mental Health
Alzheimer’s is ubiquitous. Stories of the heart-wrenching drudgery of care giving, escalating incidence rates, and the new path to a cure just around the corner are everywhere. Yet we rarely see or ...
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Alzheimer’s is ubiquitous. Stories of the heart-wrenching drudgery of care giving, escalating incidence rates, and the new path to a cure just around the corner are everywhere. Yet we rarely see or hear from anyone actually living with AD. The negative portrayals, apocalyptic projections, and promise of cures in the mass media and medical outlets are grossly inaccurate. But they are also an assault on the identities of those with Alzheimer’s. Drawing on an 18-month ethnography observing cognitive evaluations and post-diagnosis interviews with nearly 100 forgetful individuals, this book aims to chip away at this pervasive and persistent destructive trend by revealing what life with memory loss is really like. While diagnosed seniors are ultimately socialized into medicalized interpretations of their forgetfulness, most participants achieve a graceful balance between accepting the medical label and resisting the social stigma that accompanies it. In contrast to what we are led to believe, people with early AD actively and deliberately navigate their lives. Interviews with specialty clinicians and staff from the Alzheimer’s Association reveal that a biomedical ethos generates tensions that constrain the roles older forgetful people can play within these settings. Clinicians and Association staff perpetuate “myths” about “self-loss,” “impending cures,” and the economic and emotional “burden” even if they do not personally believe them. Living with AD ultimately requires managing stigma and presumptions of incompetence in addition to the associated symptoms. Unfortunately, we, the well-meaning public, and not their dementia become the major barrier to a happy life for those affected.Less
Alzheimer’s is ubiquitous. Stories of the heart-wrenching drudgery of care giving, escalating incidence rates, and the new path to a cure just around the corner are everywhere. Yet we rarely see or hear from anyone actually living with AD. The negative portrayals, apocalyptic projections, and promise of cures in the mass media and medical outlets are grossly inaccurate. But they are also an assault on the identities of those with Alzheimer’s. Drawing on an 18-month ethnography observing cognitive evaluations and post-diagnosis interviews with nearly 100 forgetful individuals, this book aims to chip away at this pervasive and persistent destructive trend by revealing what life with memory loss is really like. While diagnosed seniors are ultimately socialized into medicalized interpretations of their forgetfulness, most participants achieve a graceful balance between accepting the medical label and resisting the social stigma that accompanies it. In contrast to what we are led to believe, people with early AD actively and deliberately navigate their lives. Interviews with specialty clinicians and staff from the Alzheimer’s Association reveal that a biomedical ethos generates tensions that constrain the roles older forgetful people can play within these settings. Clinicians and Association staff perpetuate “myths” about “self-loss,” “impending cures,” and the economic and emotional “burden” even if they do not personally believe them. Living with AD ultimately requires managing stigma and presumptions of incompetence in addition to the associated symptoms. Unfortunately, we, the well-meaning public, and not their dementia become the major barrier to a happy life for those affected.
David H. Zald
- Published in print:
- 2006
- Published Online:
- February 2010
- ISBN:
- 9780198565741
- eISBN:
- 9780191723971
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198565741.003.0018
- Subject:
- Neuroscience, Behavioral Neuroscience
This chapter reviews the neuropsychological assessment of orbitofrontal functions. It starts by describing the major categories of neurological disorders that result in lesions of the orbitofrontal ...
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This chapter reviews the neuropsychological assessment of orbitofrontal functions. It starts by describing the major categories of neurological disorders that result in lesions of the orbitofrontal cortex (OFC). Traditional neuropsychological test batteries are generally insensitive to OFC dysfunction. A number of experimental tasks have been proposed as tests of OFC functions. These include objection alternation and object reversal learning tasks, gambling tasks, go/nogo tasks, olfactory recognition, theory of mind and social processing measures, and self- or family-rating scales of the patient's behavior. The sensitivity and specificity of these measures are discussed, with a particular emphasis on issues of functional localization. The chapter concludes with a description of rehabilitation programs aimed at addressing problems associated with OFC dysfunction.Less
This chapter reviews the neuropsychological assessment of orbitofrontal functions. It starts by describing the major categories of neurological disorders that result in lesions of the orbitofrontal cortex (OFC). Traditional neuropsychological test batteries are generally insensitive to OFC dysfunction. A number of experimental tasks have been proposed as tests of OFC functions. These include objection alternation and object reversal learning tasks, gambling tasks, go/nogo tasks, olfactory recognition, theory of mind and social processing measures, and self- or family-rating scales of the patient's behavior. The sensitivity and specificity of these measures are discussed, with a particular emphasis on issues of functional localization. The chapter concludes with a description of rehabilitation programs aimed at addressing problems associated with OFC dysfunction.
Po H. Lu, Negar Khanlou, and Jeffrey L. Cummings
- Published in print:
- 2006
- Published Online:
- February 2010
- ISBN:
- 9780198565741
- eISBN:
- 9780191723971
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198565741.003.0024
- Subject:
- Neuroscience, Behavioral Neuroscience
Patients with frontotemporal dementia (FTD) manifest severe behavioral and personality alterations associated with orbitofrontal cortex (OFC) dysfunction. This chapter provides a review of the ...
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Patients with frontotemporal dementia (FTD) manifest severe behavioral and personality alterations associated with orbitofrontal cortex (OFC) dysfunction. This chapter provides a review of the clinical features, neuropathology, neuroimaging, genetics, and neuropsychology of FTD as well as presenting two prototypical cases that provide a clinical picture of the disorder. Neuropathological and neuroimaging studies have identified the OFC as the brain region most prominently involved in the frontal-variant of FTD. The neuroanatomy, circuitry, and functions of the OFC are summarized, emphasizing its role in emotional and social cognition. Theories involving deficits in recognition of emotional expression, decision-making, and theory of mind have been proposed to explain the mechanism underlying the clinical expression of FTD, and the OFC is intimately involved in studies examining the neural basis underlying these deficits.Less
Patients with frontotemporal dementia (FTD) manifest severe behavioral and personality alterations associated with orbitofrontal cortex (OFC) dysfunction. This chapter provides a review of the clinical features, neuropathology, neuroimaging, genetics, and neuropsychology of FTD as well as presenting two prototypical cases that provide a clinical picture of the disorder. Neuropathological and neuroimaging studies have identified the OFC as the brain region most prominently involved in the frontal-variant of FTD. The neuroanatomy, circuitry, and functions of the OFC are summarized, emphasizing its role in emotional and social cognition. Theories involving deficits in recognition of emotional expression, decision-making, and theory of mind have been proposed to explain the mechanism underlying the clinical expression of FTD, and the OFC is intimately involved in studies examining the neural basis underlying these deficits.
Timothy A. Salthouse
- Published in print:
- 2009
- Published Online:
- May 2010
- ISBN:
- 9780195372151
- eISBN:
- 9780199776948
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195372151.003.0005
- Subject:
- Psychology, Cognitive Neuroscience, Cognitive Psychology
This chapter focuses on cognitive functioning in late adulthood. It discusses three related topics: dementia, the preclinical phase of dementia, and the risk factors for cognitive decline and ...
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This chapter focuses on cognitive functioning in late adulthood. It discusses three related topics: dementia, the preclinical phase of dementia, and the risk factors for cognitive decline and dementia. Dementia, and Alzheimer's disease in particular, is characterized by severe impairment in cognitive functioning. It is a particularly devastating disease because it destroys one's sense of self, and there are currently no effective treatments to prevent or even delay the disease. Research has revealed differences in cognitive performance between individuals who will and will not develop the disease several years prior to the eventual diagnosis. However, what is responsible for these relations and whether it is meaningful to refer to a distinct diagnostic category are still controversial issues.Less
This chapter focuses on cognitive functioning in late adulthood. It discusses three related topics: dementia, the preclinical phase of dementia, and the risk factors for cognitive decline and dementia. Dementia, and Alzheimer's disease in particular, is characterized by severe impairment in cognitive functioning. It is a particularly devastating disease because it destroys one's sense of self, and there are currently no effective treatments to prevent or even delay the disease. Research has revealed differences in cognitive performance between individuals who will and will not develop the disease several years prior to the eventual diagnosis. However, what is responsible for these relations and whether it is meaningful to refer to a distinct diagnostic category are still controversial issues.
