Aging and Neuropsychological Assessment by Asenath LaRue

By Asenath LaRue

It is a privilege to be requested to put in writing the foreword for therefore first-class a e-book, so well timed and loads wanted by way of the sphere. not just is it most unique nowadays to have a unmarried­ authored quantity on so extensive a subject, yet Dr. los angeles Rue has performed a great activity of offering either a scholarly treatise and a realistic guide. With a burgeoning aged inhabitants and the corresponding raise in geriatric psychopathology, the desires of psychological well-being prone are exceeding by means of a long way the provision of acceptable prone. in order to meet this desire, psychiatry, drugs, neurology, pharmacology, psychology, nursing, and social paintings have all made the availability of educating in geriatrics and gerontology a excessive priority-but I worry we're wasting the race. for instance, multidisciplinary groups that determine, diagnose, and deal with psychological health and wellbeing issues in aged sufferers are incomplete with no scientific psychologists and neuropsy­ chologists, and but there's slightly a handful of medical psychologists informed in facing geriatric sufferers. we will anticipate our hands the extra ones graduated every year. In hospitals, clinics, and personal practices around the state, another way expert psychologists are unprepared to answer the specific psychological future health wishes of the aged. a number of CME courses are aiding to deal with this desire, yet they're truly no longer enough.

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In the locus ceruleus, neurofibrillary tangles were reported in 10% to 20% of patients dying between the ages of 60 and 90 and in all patients over 100 years of age in one investigation (Tomonago, 1979). Neurofibrillary tangles are noted in much greater concentration and with wider distribution in Alzheimer's disease than in normal aging and have been observed in other neurological disorders including dementia pugilistica and Down's syndrome. Granulovacuolar Degeneration Granulovacuolar degeneration refers to the accumulation of distinctive vesicles with a central dark core within the cytoplasm of neurons.

Associations between cognition and neurotransmitter variables have not been extensively studied in normal older people. At present, there is clearer evidence for correlations in pathological conditions such as Alzheimer's disease or Parkinson's disease, where the neurotransmitter changes are more pronounced and behavioral impairment is more severe. Researchers have only begun to examine imbalance among neurotransmitters as a possible cause of aging change, although many believe that interactions between systems 38 CHAPTER 2 will prove to be more important than alterations in single neurotransmitters (Timiras, 1988; Whitehouse, 1987).

Rogers and Bloom (1985) provided a comprehensive overview of neurotransmission in aging, and Whitehouse and Au (1986) examined receptor changes with age. Excellent discussions of interrelations between behavior and neurotransmitter changes in old age include those of Bartus, Dean, Beer, and Lippa (1982) and Kubanis and Zornetzer (1981). 2A, from Timiras (1988), provides a simplified model of a junction (synapse) between two cells and identifies components of the cholinergic neurotransmitter system.

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