Question

Scenario

You are the nurse working triage in the emergency department (ED). This afternoon a woman brings in her father, ALI, a 72-year-old who is a retired doctor. The daughter reports that over the past several months she has noticed her father has progressively had problems with his mental capacity. These changes have developed gradually but seem to be getting worse. At times he is alert, and at other times he seems disoriented, depressed, and tearful. He is forgetting things and doing things out of the ordinary, such as placing the milk in the cupboard and sugar in the refrigerator. He had difficulty finding objects in the kitchen and at times forgets where his room is.

This morning he thought it was nighttime and wondered what his daughter was doing at his house. He could not pour his coffee, and he seems to be getting more agitated. ALI reports that he has been having memory problems for the past year and at times has difficulty remembering the names of family members and friends.

A review of his past medical history (PMH) is significant for hypercholesterolemia and coronary artery disease (CAD). He had a myocardial infarction (MI) 5 years ago. ALI’s vital signs (VS) today are all within normal limits (WNL).

Q:Discuss three cognitive changes seen in several elderly patients?                

Answer 1

Cognitive changes are so far normal process in aging. Alterations in brain structure and function are intimately tied to alterations in cognitive functions. Main three cognitive changes seen in several elderly patients are:

1.Slower inductive reasoning /slower problem solving

2.Diminised visuospatial orientation

3.Loss in verbal memory and changes in verbal activity

*Slower inductive reasoning /slower problem solving

Executive functioning like inductive reasoning, problem solving can also be decline as by age processes. Inductive reasoning or problem solving as measured by verbal and mathematical reasoning tasks.

*Diminished visuospatial orientation

Visuospatial abilities includes object perception, the abilities to recognize familiar objects, the ability to appreciate the physical location of objects, which can also be decline by aging.

*Loss of verbal memory and changes in verbal ability

Most common cognitive changes among elderly is change in memory or loss of memory. Memory changes may be related to slowed processing speed, decreased use of strategies to improve learning and memory.

Participation in certain activities, building cognitive resources and engaging in cognitive retaining may all be approaches to achieving successful cognitive aging.