67-Year-Old Woman Case (Essay Sample)

67-Year-Old Woman Case Student’s Name Course Code: Course Name Name of your Institution Instructor’s Name Date of Submission 67-Year-Old Woman Case Considering the information, Alzheimer’s Disease appears to be a likely diagnosis for the 67-year-old woman. This degenerative neurological illness mainly impairs memory and cognition, causing forgetfulness, confusion, restlessness, inability to recall recent events and people’s names, and disorientation even in familiar environments. These are all signs of the early stages of Alzheimer’s Disease. The symptoms of extreme cognitive disorientation and agitation exhibited by the 67-year-old woman over the two preceding years, including getting lost in familiar neighborhoods, could point to various diagnoses. Dementia, a frequent source of cognitive deterioration in seniors, might be such an illness. It is classified as a chronic degenerative condition that affects several processes related to perception and cognition, namely memory, thinking, and conduct ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"38xz5OQb","properties":{"formattedCitation":"(McGirr et al., 2022)","plainCitation":"(McGirr et al., 2022)","noteIndex":0},"citationItems":[{"id":2657,"uris":["http://zotero.org/users/local/MgqJMbgS/items/R9GB7FW2"],"itemData":{"id":2657,"type":"article-journal","abstract":"Background and Objectives\nMild cognitive impairment (MCI) is an at-risk state for dementia; however, not all individuals with MCI transition to dementia, and some revert to normal cognition (NC). Here, we investigate whether mild behavioral impairment (MBI), the late-life onset of persistent neuropsychiatric symptoms (NPS), improves the prognostic specificity of MCI.\n\nMethods\nParticipants with MCI from the National Alzheimer's Coordinating Center Uniform Data Set were included. NPS were operationalized with the Neuropsychiatric Inventory Questionnaire to identify participants without NPS and those with MBI (persistent, late-onset NPS). Individuals with late-onset NPS not meeting the MBI persistence criterion (NPS_NOT_MBI) were retained for secondary analyses. Progression to dementia, stable MCI, and reversion to NC after 3 years of follow-up were defined per National Institute on Aging–Alzheimer’s Association and Petersen criteria.\n\nResults\nThe primary sample consisted of 739 participants (NPS− n = 409 and MBI+ n = 330; 75.16 ± 8.6 years old, 40.5% female). After 3 years, 238 participants (33.6%) progressed to dementia, and 90 (12.2%) reverted to NC. Compared to participants without NPS, participants with MBI were significantly more likely to progress to dementia (adjusted odds ratio [AOR] 2.13, 95% CI 1.52–2.99), with an annual progression rate of 14.7% (vs 8.3% for participants with MCI without NPS). Compared to participants without NPS, participants with MBI were less likely to revert to NC (AOR 0.48, 95% CI 0.28–0.83, 2.5% vs 5.3% annual reversion rate). The NPS_NOT_MBI group (n = 331, 76.5 ± 8.6 years old, 45.9% female) were more likely to progress to dementia (AOR 2.18, 95% CI 1.56–3.03, 14.3% annual progression rate) but not less likely to revert to NC than those without NPS. Accordingly, both NPS_NOT_MBI and MBI+ participants had lower Mini-Mental State Examination scores than NPS− participants after 3 years.\n\nDiscussion\nLate-onset NPS improve the specificity of MCI as an at-risk state for progression to dementia. However, only persistent late-onset NPS are associated with a lower likelihood of reversion to NC, with transient NPS (i.e., NPS_NOT_MBI) not differing from the NPS− group. Clinical prognostication can be improved by incorporating late-onset NPS, especially those that persist (i.e., MBI), into risk assessments. Clinical trials may benefit from enrichment with these higher-risk participants with MCI.","container-title":"Neurology","DOI":"10.1212/WNL.0000000000200256","ISSN":"0028-3878","issue":"21","journalAbbreviation":"Neurology","note":"PMID: 35351783\nPMCID: PMC9169943","page":"e2132-e2139","source":"PubMed Central","title":"Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late-Onset Neuropsychiatric Symptoms","volume":"98","author":[{"family":"McGirr","given":"Alexander"},{"family":"Nathan","given":"Santhosh"},{"family":"Ghahremani","given":"Maryam"},{"family":"Gill","given":"Sascha"},{"family":"Smith","given":"Eric E."},{"family":"Ismail","given":"Zahinoor"}],"issued":{"date-parts":[["2022",5,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (McGirr et al., 2022). Characterized by a greater decline of cognitive function than typically expected for one’s age, Mild Cognitive Impairment (MCI) warrants consideration. Though the symptoms may not substantially impede daily activities, as ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FHivrzXO","properties":{"formattedCitation":"(McGirr et al., 2022)","plainCitation":"(McGirr et al., 2022)","noteIndex":0},"citationItems":[{"id":2657,"uris":["http://zotero.org/users/local/MgqJMbgS/items/R9GB7FW2"],"itemData":{"id":2657,"type":"article-journal","abstract":"Background and Objectives\nMild cognitive impairment (MCI) is an at-risk state for dementia; however, not all individuals with MCI transition to dementia, and some revert to normal cognition (NC). Here, we investigate whether mild behavioral impairment (MBI), the late-life onset of persistent neuropsychiatric symptoms (NPS), improves the prognostic specificity of MCI.\n\nMethods\nParticipants with MCI from the National Alzheimer's Coordinating Center Uniform Data Set were included. NPS were operationalized with the Neuropsychiatric Inventory Questionnaire to identify participants without NPS and those with MBI (persistent, late-onset NPS). Individuals with late-onset NPS not meeting the MBI persistence criterion (NPS_NOT_MBI) were retained for secondary analyses. Progression to dementia, stable MCI, and reversion to NC after 3 years of follow-up were defined per National Institute on Aging–Alzheimer’s Association and Petersen criteria.\n\nResults\nThe primary sample consisted of 739 participants (NPS− n = 409 and MBI+ n = 330; 75.16 ± 8.6 years old, 40.5% female). After 3 years, 238 participants (33.6%) progressed to dementia, and 90 (12.2%) reverted to NC. Compared to participants without NPS, participants with MBI were significantly more likely to progress to dementia (adjusted odds ratio [AOR] 2.13, 95% CI 1.52–2.99), with an annual progression rate of 14.7% (vs 8.3% for participants with MCI without NPS). Compared to participants without NPS, participants with MBI were less likely to revert to NC (AOR 0.48, 95% CI 0.28–0.83, 2.5% vs 5.3% annual reversion rate). The NPS_NOT_MBI group (n = 331, 76.5 ± 8.6 years old, 45.9% female) were more likely to progress to dementia (AOR 2.18, 95% CI 1.56–3.03, 14.3% annual progression rate) but not less likely to revert to NC than those without NPS. Accordingly, both NPS_NOT_MBI and MBI+ participants had lower Mini-Mental State Examination scores than NPS− participants after 3 years.\n\nDiscussion\nLate-onset NPS improve the specificity of MCI as an at-risk state for progression to dementia. However, only persistent late-onset NPS are associated with a lower likelihood of reversion to NC, with transient NPS (i.e., NPS_NOT_MBI) not differing from the NPS− group. Clinical prognostication can be improved by incorporating late-onset NPS, especially those that persist (i.e., MBI), into risk assessments. Clinical trials may benefit from enrichment with these higher-risk participants with MCI.","container-title":"Neurology","DOI":"10.1212/WNL.0000000000200256","ISSN":"0028-3878","issue":"21","journalAbbreviation":"Neurology","note":"PMID: 35351783\nPMCID: PMC9169943","page":"e2132-e2139","source":"PubMed Central","title":"Progression to Dementia or Reversion to Normal Cognition in Mild Cognitive Impairment as a Function of Late-Onset Neuropsychiatric Symptoms","volume":"98","author":[{"family":"McGirr","given":"Alexander"},{"family":"Nathan","given":"Santhosh"},{"family":"Ghahremani","given":"Maryam"},{"family":"Gill","given":"Sascha"},{"family":"Smith","given":"Eric E."},{"family":"Ismail","given":"Zahinoor"}],"issued":{"date-parts":[["2022",5,24]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} McGirr et al. (2022) assert, MCI is often viewed as an intermediary between usual aging and dementia. Depressive mood disorder may also explain the woman’s symptoms. According to ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"JLVkw7ow","properties":{"formattedCitation":"(Howes Vallis et al., 2023)","plainCitation":"(Howes Vallis et al., 2023)","noteIndex":0},"citationItems":[{"id":2660,"uris":["http://zotero.org/users/local/MgqJMbgS/items/RIT2Y674"],"itemData":{"id":2660,"type":"article-journal","abstract":"BACKGROUND: Cross-sectional studies report high levels of depressive symptoms during the COVID-19 pandemic, especially in youth and females. However, longitudinal research comparing depressive symptoms before and during the pandemic is lacking. Little is known about how the pandemic affected individuals with familial history of mental illness. The present study examines the impact of the pandemic on youth depressive symptoms, including offspring of parents with major mood and psychotic disorders.\nMETHODS: Between March 2018 and February 2020, we measured depressive symptoms in 412 youth aged 5-25 years. We measured depressive symptoms again in 371 (90%) of these youth between April 2020 and May 2022. Two thirds (249) participants had a biological parent with a major mood or psychotic disorder. We tested the effect of the pandemic by comparing depression symptoms before and after March 2020. We examined age, sex, and family history as potential moderators.\nRESULTS: We found an overall small increase in youth depressive symptoms (b = 0.07, ...