A look at the research on Alzheimer's disease and other forms of dementia; new discoveries that some forms are genetic.

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Dementia: Does it Discriminate and Can we Stop it?
An In-depth Look at the Mechanics of Dementia
Dennel B. TyonDennel B. Tyon
Argosy UniversityArgosy University
FP6540: Forensic Psychology SeminarFP6540: Forensic Psychology Seminar
Instructor: David ArenaInstructor: David Arena
October 19, 2015October 19, 2015

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Our Current Situation
almostfive-and-a-halfmillionpeople,intheUnitedStates,
alone,currentlyhaveAlzheimer’s

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Our Current Situation (cont)
higher than forty percent
of individuals with
Alzheimer's are
over the age of 75

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Our Current Situation (cont)
nearly two-thirds of
the individuals in
America, who have
Alzheimer’s, are
female

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How Did This Happen?
 improvementofphysicalhealthcarecreatingthisparadigm*
 someevidenceexiststhatAlzheimer’sandotherformsofdementiaare
genetic
 it is most certainly not a part of the
‘normal’ aging cycle

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Current Research
 Younger Subjects
 Less neural activity
at higher levels of
demand
 lesser anterior/right
hemisphere activity
during decision-
making process
 Older Subjects
 Neural activity
increases more at
lesser levels of demand
 Reach capacity limits
sooner
 Less efficient
processing
 Decreased accuracy

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Current Research (cont.)
 Younger subjects also had:
– A higher rate of accuracy
– More anterior (frontal processor) activity as
task demands increased
 Older subjects also show:
– Less efficient processing
– Diminished availability of resources
– Over-recruitment of neural activity

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A Growing Problem
 as our population ages, so does the
prevalence of cognitive impairment*
 more than half of elderly receive their
mental health care from their PCP
 screening in these instances, where
medical treatment effectiveness is
modest at best, is complex

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Percentage of Population over 65 with Alzheimer's
0
10
20
30
40
50
60
70
80
90
100
2010
Total
Men
Women

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Recommendations
 New screening tests need to be
developed for use in primary care
facilities
 Tests need to be:
– Easier to understand
– Easier to administer
– Easier to analyze

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Recommendations (cont)
This will allow more primary
care doctors to effectively
assess for dementia and
more effectively treat it

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Currently Used Screening Tools
MMSE (Mini Mental
Status Exam)
Clock Drawing Delayed Word
Recall
Most
commonly
used by
primary care
physicians
Quick and
easy…
Simple to
understand
Simple to
administer/ can
be performed
during routine
exam.

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Vision for the Future
 development of easier-to-use,
screening and assessment tools for use
in primary care clinical practice*
 further research on the mechanics of
dementia, and repeated surveys,
including younger populations, across
all demographics, need to be completed
in the years to come

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Summary
 the population is rapidly growing older.
 dementia is becoming more prominent.
 clinical practices will be the primary
screening and assessment point of the
future for dementia patients.
 further research is needed on younger
populations, to find cause and cure.

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Reference:
Algase, D., Beattie, E., Song, J., Milke, D., Duffield, D., & Cowan, B.
(2003). Validation of the Algase Wandering Scale (Version 2) in
a cross cultural sample. University of Michigan School of
Nursing, Special Section – Behavioral Symptoms of Dementia:
Their Measurement and Intervention; Taylor & Francis Ltd.
Alzheimer’s Association. (2015). Alzheimer’s disease facts and
figures [website]. Alzheimer’s & Dementia 2015; 11(3)332
Report.
Angold, A., and Egger H. (2007). Preschool psychopathology:
lessons for the lifespan. The Authors Journal compilation,
Association for Child and Adolescent Mental Health, Blackwell
Publishing, Oxford, UK.
Argosy. (2015). Forensic Psychology Seminar, Module 5, Lecture
Notes; Argosy University Online.

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Reference (cont.):
Borson, S., Scanlan, J., Chen, P., and Ganguli, M. (20003. The
mini-cog as a screen for dementia: Validation in a population-
based sample. American Geriatrics Society.
Daffner, K., Chong, H., Sun, X., Tarbi, E., Riis, J., McGinnis, S., and
Holcomb, P. (2011). Mechanisms underlying age-and
performance-related differences in working memory. Journal of
Cognitive Neuroscience 23:6, Massachusetts Institute of
Technology.
Eisenstein, N., Engelhart, C., Johnson, V., Wolf, J., Williamson, J.,
and Losonczy, M. (2002). Normative data for healthy elderly
persons with the neurobehavioral cognitive status exam. Applied
Neuropsychology, 9:2, pp. 110-113; Mental Health and
Behavioral Scienses, Lyons, NJ 07939.

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Reference (cont.):
Iracleous, P., Nie, J., Tracy, C., Moineddin, R., Ismail, Z., Shulman, K., and
Upshur, R. (2009). Primary care physicians’ attitudes towards cognitive
screening: findings from a national postal survey. Wiley InterScience,
John Wiley & Sons, Ltd.
Kaplan, R., Saccuzzo, D. (2012). Psychological testing: principles,
applications, and issues, 8e, 8th Edition; CengageLearning,
VitalSourceBookshelf.
Kapp, M. (2002). Legal standards for the medical diagnosis and treatment
of dementia. The Journal of Legal Medicine, 23:359-402; Taylor &
Francis.
Zakzanis, K., Andrikopoulos, J., Young, D., Campbell, Z., and Sethian, T.
(2003). Neuropsychological differentiation of late-onset schizophrenia
and dementia of the alzheimer’s type. Applied Neuropsychology,
Lawrence Eribaum Associates, Inc., Division of Life Sciences,
University of Toronto, Scarborough, Ontario.