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Health Differences Across the Lifespan 2 Study Guide Stage 3: (1-2 years) o The need to taste, chew, and examine any object small enough to be placed in the mouth (hyperorality) o The need to compulsively touch and examine every object in the environment (hyperetetamorphosis) o Progressive motor deterioration, including inability to walk, sit up, or even smile o Progressive decrease in response to environmental stimuli, leading to total non- responsiveness or vegetative state o Severe decline in cognitive function, losing the ability to recognize others or even self Screening Tools • Folstein mini mental status examination: an organic screening tool useful for differentiating dementia from functional states; total score of 30 points, a score of 9-12 indicates a high likelihood of organic illness • Cognitive performance scale : a subscale from nursing home minimal data set MDS; ranges from 0 (cognitively intact) to 6 (very severe cognitive impairment); items assessed on MDS include comatose status, short term memory, decision making ability, making oneself understood, eating, and performance • Geriatric depression screening scale (GDSS): a useful screening tool especially developed for older adults to screen for possible depression which can mimic dementia; a 15-30 item questionnaire with dichotomous yes or no answers; easy to administer in approximately 15- 20 minutes; certain items are reverse scored for more accurate assessment; results indicate absence of or mild depression (0-10), moderate depression (11-20), or severe depression (21- 30) using the 30 itemquestionnaire Delirium may coexist with dementia, making accurate assessment and appropriate treatment difficult. The most prevalent primary dementia is Alzheimer’s type (occurs in 50% of older adults). Vascular dementia resulting from a narrowing of arteries affects 20-50% of older adults. The less common forms of dementia stem from degenerative nervous system disorders (Parkinson’s disease) and other pathological process (AIDS dementia complex). Pseudodementia is a reversible disorder that frequently mimics dementia. • Depression is frequently misdiagnosed or overlooked in older adults. • Other causes include drug toxicity, metabolic disorders, infections, nutritional deficiencies, and chronic lung or heart disease. Pseudodelirium is symptoms of delirium without any identifiable organic cause. • Symptoms may be caused from psychosocial stress, sensory deprivation, or sensory overload (ICU psychosis). • A preexisting biochemical imbalance, such as a mood disorder, anxiety, schizophrenia, or dementia can make someone vulnerable topseudodelirium. •

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