Describe major changes that occurs on the neurological system associated to age. Include changes on central nervous system and peripheral nervous system.
Define delirium and dementia specified similarities and differences and describe causes for each one. Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources
Major Changes in the Neurological System Associated with Age
Aging brings about several significant changes in the neurological system, impacting both the central nervous system (CNS) and the peripheral nervous system (PNS). Understanding these changes is crucial for managing and providing appropriate care to the elderly population.
Changes in the Central Nervous System (CNS)
Brain Volume and Weight: With age, there is a gradual decrease in brain volume and weight. This reduction is primarily due to the loss of neurons, which is more pronounced in certain areas like the frontal cortex. The shrinkage of the brain can affect cognitive functions and processing speed.
Neurotransmitter Systems: Aging affects neurotransmitter systems, leading to a decline in the levels of neurotransmitters such as dopamine, acetylcholine, and serotonin. This decline can contribute to slower synaptic transmission and affect mood, cognition, and motor functions.
Cerebral Blood Flow: There is a decrease in cerebral blood flow as the blood vessels in the brain become less flexible and may narrow due to atherosclerosis. Reduced blood flow can impair the delivery of oxygen and nutrients to brain tissues, affecting overall brain function.
White Matter Changes: The integrity of white matter, which comprises nerve fibers that connect different brain regions, deteriorates with age. This can result in slower cognitive processing and reduced coordination of brain functions.
Neuroplasticity: While neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections, decreases with age, it does not cease entirely. The elderly brain still retains some capacity to adapt and learn, though at a slower rate.
Changes in the Peripheral Nervous System (PNS)
Nerve Conduction Velocity: The speed at which electrical impulses are conducted along peripheral nerves decreases with age. This slowing can lead to delayed reaction times and diminished reflexes.
Sensory Function: There is a decline in sensory functions, including vision, hearing, taste, and smell. For example, age-related hearing loss (presbycusis) and reduced tactile sensitivity can impact daily activities and quality of life.
Autonomic Nervous System: The autonomic nervous system, which controls involuntary functions such as heart rate and digestion, also undergoes changes. Elderly individuals may experience orthostatic hypotension, where blood pressure drops significantly upon standing, leading to dizziness and increased fall risk.
Delirium and Dementia: Definitions, Similarities, and Differences
Definitions
Delirium is an acute, often sudden onset of confusion characterized by fluctuating levels of consciousness, disorganized thinking, and inattention. It is typically reversible and caused by an underlying medical condition, such as infection, medication toxicity, or metabolic imbalances.
Dementia is a chronic and progressive decline in cognitive function, severe enough to interfere with daily life and independent functioning. Alzheimer’s disease is the most common form of dementia, characterized by memory loss, language difficulties, and impaired reasoning.
Similarities
Cognitive Impairment: Both delirium and dementia involve cognitive deficits, including memory impairment, confusion, and difficulties with attention and executive function.
Impact on Daily Activities: Both conditions can significantly impact the ability to perform daily activities and maintain independence.
Overlap in Symptoms: Symptoms of delirium and dementia can overlap, especially in advanced stages of dementia, where patients may exhibit acute confusion and altered mental status similar to delirium.
Differences
Onset and Duration: Delirium has a rapid onset, occurring within hours to days, and is typically reversible with treatment of the underlying cause. In contrast, dementia develops gradually over months to years and is generally irreversible.
Course and Fluctuation: Delirium often has a fluctuating course, with periods of lucidity and confusion, whereas dementia has a steady, progressive decline in cognitive function.
Underlying Causes: Delirium is usually triggered by acute medical conditions or environmental factors, such as infections, medications, or surgery. Dementia, on the other hand, is primarily caused by neurodegenerative diseases like Alzheimer’s, vascular changes, or other chronic conditions.
Causes of Delirium and Dementia
Causes of Delirium
Infections: Urinary tract infections, pneumonia, and sepsis are common infections that can precipitate delirium.
Medications: Polypharmacy and adverse drug reactions, especially from anticholinergics, benzodiazepines, and opioids, are frequent causes.
Metabolic Imbalances: Electrolyte disturbances, dehydration, and hypoglycemia can lead to delirium.
Environmental Factors: Hospitalization, surgery, and sensory deprivation can also trigger delirium, especially in vulnerable elderly patients.
Causes of Dementia
Neurodegenerative Diseases: Alzheimer’s disease, Parkinson’s disease, and frontotemporal dementia are primary causes of dementia.
Vascular Changes: Conditions like stroke, chronic hypertension, and atherosclerosis can lead to vascular dementia.
Genetic Factors: Genetic mutations and family history can increase the risk of developing certain types of dementia.
Lifestyle and Health Conditions: Factors such as smoking, obesity, diabetes, and lack of physical activity can contribute to the development of dementia.
Conclusion
Understanding the neurological changes associated with aging and differentiating between delirium and dementia is crucial for healthcare providers. Effective management requires recognizing the symptoms, understanding the underlying causes, and providing appropriate interventions to improve patient outcomes.
References
Miller, C. A. (2018). Nursing for Wellness in Older Adults. Wolters Kluwer.
Inouye, S. K., Westendorp, R. G. J., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet, 383(9920), 911-922. Changes on Central Nervous System appeared first on Nursing Depo.
