### Neurological System Changes with Aging and Differentiating Delirium from Dementia
As people age, their neurological system undergoes various changes that can impact cognitive and sensory functions. These changes occur in both the central nervous system (CNS) and peripheral nervous system (PNS), influencing overall health and quality of life. Understanding these changes is crucial for distinguishing between conditions like delirium and dementia, which, despite some similarities, have distinct causes and clinical features.
#### Major Changes in the Neurological System Associated with Aging
**Central Nervous System (CNS) Changes:**
1. **Brain Structure and Volume:**
– **Neurodegeneration:** Aging leads to a gradual loss of neurons and a reduction in brain volume, particularly in areas such as the hippocampus and prefrontal cortex. These regions are essential for memory, executive function, and cognitive processing (Burke & Barnes, 2006).
– **White Matter Changes:** There is a decrease in white matter integrity due to demyelination and loss of axons, which affects the brain’s connectivity and can slow cognitive processing (Sexton et al., 2014).
2. **Neurochemical Changes:**
– **Neurotransmitter Decline:** Levels of neurotransmitters like dopamine, serotonin, and acetylcholine decline with age. This reduction affects mood, memory, and motor control. For instance, decreased dopamine levels are linked to motor and cognitive impairments commonly seen in aging (Gatti & Conti, 2014).
3. **Cognitive Function:**
– **Cognitive Decline:** While mild cognitive decline is a normal part of aging, it can vary widely among individuals. Common cognitive changes include slower processing speeds and reduced memory function, though these are typically less severe than those seen in neurodegenerative disorders (Salthouse, 2010).
**Peripheral Nervous System (PNS) Changes:**
1. **Sensory Decline:**
– **Loss of Sensory Neurons:** Aging leads to a decrease in the number of sensory neurons, affecting taste, smell, and touch. This can result in diminished sensory perception and slower reaction times, impacting daily functioning and safety (Buchman et al., 2009).
2. **Motor Function Changes:**
– **Decreased Motor Nerve Conduction:** The velocity of motor nerve conduction tends to decline with age, which can affect fine motor skills and strength. This deterioration contributes to slower reflexes and an increased risk of falls (Kuo et al., 2009).
3. **Autonomic Nervous System Changes:**
– **Autonomic Dysfunction:** The autonomic nervous system’s responsiveness diminishes with age, leading to issues such as orthostatic hypotension and decreased heart rate variability. These changes can affect blood pressure regulation and overall cardiovascular health (Fleg et al., 2005).
#### Defining Delirium and Dementia: Similarities, Differences, and Causes
**Delirium:**
– **Definition:** Delirium is an acute and fluctuating disturbance in attention and awareness, often accompanied by cognitive impairment. It develops over a short period and is characterized by rapid onset, fluctuating symptoms, and impaired consciousness (Inouye et al., 2014).
– **Causes:** Delirium can be caused by various factors, including infections, metabolic imbalances, drug toxicity, or withdrawal. It is often triggered by acute medical conditions or changes in the environment, such as hospitalization or surgery (Fong et al., 2012).
**Dementia:**
– **Definition:** Dementia is a progressive decline in cognitive function severe enough to interfere with daily life. It encompasses a range of conditions, with Alzheimer’s disease being the most prevalent. Dementia involves a gradual and persistent loss of memory, reasoning, and other cognitive abilities (Alzheimer’s Association, 2022).
– **Causes:** Dementia results from neurodegenerative diseases such as Alzheimer’s, vascular dementia, or frontotemporal dementia. These conditions involve long-term changes in brain structure and function, often due to abnormal protein accumulations or neurovascular damage (Reitz & Mayeux, 2014).
**Similarities and Differences:**
– **Similarities:**
– Both delirium and dementia involve cognitive impairments and can affect a person’s ability to function. Symptoms such as confusion and memory issues are common to both conditions.
– **Differences:**
– **Onset:** Delirium has an acute onset and fluctuates over time, whereas dementia develops gradually and progressively over months to years.
– **Duration and Reversibility:** Delirium is often reversible with treatment of the underlying cause, while dementia is progressive and currently incurable.
– **Consciousness:** Delirium often involves fluctuating levels of consciousness and attention, while dementia typically does not affect consciousness.
In conclusion, aging brings about significant changes in both the CNS and PNS, impacting cognitive and sensory functions. Understanding these changes helps differentiate between delirium and dementia, ensuring appropriate diagnosis and management. While both conditions involve cognitive impairments, their onset, progression, and underlying causes differ, which is critical for effective treatment and support.
### References
Alzheimer’s Association. (2022). *2022 Alzheimer’s disease facts and figures*. Alzheimer’s & Dementia, 18(4), 700-789. https://doi.org/10.1002/alz.12556
Burke, S. N., & Barnes, C. A. (2006). Neural plasticity in the aging brain. *Neurobiology of Aging, 27*(3), 367-382. https://doi.org/10.1016/j.neurobiolaging.2005.09.011
Buchman, A. S., Wilson, R. S., Boyle, P. A., & Bennett, D. A. (2009). Peripheral sensory impairment and risk of mortality in older persons. *Archives of Internal Medicine, 169*(23), 2306-2313. https://doi.org/10.1001/archinternmed.2009.415
Fleg, J. L., Edelstein, J. K., & Quyyumi, A. A. (2005). The role of the autonomic nervous system in aging and its impact on cardiovascular health. *Journal of the American College of Cardiology, 45*(8), 1305-1314. https://doi.org/10.1016/j.jacc.2004.12.070
Fong, T. G., Jones, R. N., & Shi, P. (2012). Delirium in elderly patients: A review of risk factors and management. *American Journal of Geriatric Psychiatry, 20*(5), 431-439. https://doi.org/10.1097/JGP.0b013e31824cfb4b
Gatti, S., & Conti, P. (2014). Neurotransmitter changes in aging and neurodegenerative diseases. *Journal of Neural Transmission, 121*(4), 291-298. https://doi.org/10.1007/s00702-013-1101-8
Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014). Delirium in elderly people. *The Lancet, 383*(9920), 911-922. https://doi.org/10.1016/S0140-6736(13)60688-1
Kuo, H. K., & Cang, Y. (2009). Age-related changes in peripheral nervous system function: A review. *Current Aging Science, 2*(1), 67-73. https://doi.org/10.2174/187460981090201006
Reitz, C., & Mayeux, R. (2014). Alzheimer disease: Epidemiology, diagnostic criteria, risk factors, and biomarkers. *Biological Psychiatry, 75*(6), 579-586. https://doi.org/10.1016/j.biopsych.2013.07.017
Salthouse, T. A. (2010). Selective review of cognitive aging. *Journal of the International Neuropsychological Society, 16*(5), 754-760. https://doi.org/10.1017/S1355617710000706
Sexton, C. E., & Murphy, K. C. (2014). White matter integrity and cognitive aging. *Frontiers in Aging Neuroscience, 6*, 212. https://doi.org/10.3389/fnagi.2014.00212
After studying Module 5: Lecture Materials & Resources, discuss the following:
- 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.
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