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For a glossary on caregiving, go to Second Opinion, Caregiver Burnout (Episode 507)
For a glossary on end-of-life planning, go to Second Opinion, End of Life (Episode 313).
Acetylcholine
A chemical in the brain that plays a key role in memory, learning, and many other brain functions. Research has indicated that lower levels of acetylcholine are associated with Alzheimer's disease.
Acquisition
In terms of memory, acquisition is the first step in forming memories and refers to gaining a new piece of information which is first put into short-term memory.
Activities of Daily Living (ADLs)
Activities of daily living (ADLs) include eating, bathing, grooming, dressing and going to the toilet. People with dementia may need aid to perform these tasks. Questions about ADLs help decide what type of care a person needs.
Acute Care (Hospital Care)
Acute care is a medical setting such as a hospital, intensive care unit or emergency department.
Adult Day Care
Adult day care is a community program for disabled adults. In this safe setting, people can socialize, participate in activities and get health care. Day care centers are open during business hours on weekdays. Some programs also run during the evenings and on weekends.
Advance Directive
An advance directive is a legal document. It tells what kind of medical treatment you would like if your life is in danger and you can't communicate. Advance directives include:
Age-associated Memory Impairment
Normal forgetfulness that increases with age.
Aggression
Hitting, pushing, or threatening behavior that commonly occurs when a caregiver attempts to help an individual with Alzheimer's with daily activities, such as dressing. It is important to control such behavior because aggressive persons can cause injury to themselves and others.
Agitation
Vocal or motor behavior (screaming, shouting, complaining, moaning, cursing, pacing, fidgeting, wandering, etc.) that is disruptive, unsafe, or interferes with the delivery of care in a particular environment. An abnormal behavior is considered agitation only if it poses risk or discomfort to the individual with Alzheimer's or his/her caregiver. Agitation can be a nonspecific symptom of one or more physical or psychological problems (e.g., headache, depression).
Agnosia
An impaired ability to recognize or identify objects, even though sensory abilities are intact.
Alzheimer's Disease
Named for Dr. Alois Alzheimer, who first described the disease in 1907, Alzheimer's disease causes gradually increasing dementia, including memory loss, confusion, problems with judgment, planning and concentration, and personality changes; in its later stages it also affects physical abilities. The disease's causes, cures and preventions are unknown.
Amyloid Plaques
Dense deposits of beta-amyloid, pieces of damaged nerve cells, and other proteins. Found in the brains of virtually all people with Alzheimer's disease.
Aphasia
A partial or complete inability to use or understand language.
Apraxia
Difficulty performing motor activities, even though the person's movement, senses, and ability to comprehend what is being asked are still intact. Apraxia is basically a disconnect between the idea of a task and its execution.
Assessment
An assessment of mental status is a test of a person's ability to think, feel and react to others. A doctor usually performs a mental status assessment.
Behavioral Symptoms
In Alzheimer's disease, the symptoms that relate to action or emotion, such as wandering, depression, anxiety, hostility, and sleep disturbances.
Brain
One of the two components of the central nervous system, the brain is the center of thought and emotion. It is responsible for the coordination and control of bodily activities, and the interpretation of information from the senses (sight, hearing, smell, etc.).
Caregiver Burnout
A common feeling of helplessness and frustration among caregivers dealing with endless demands upon their time, energy, emotions, finances and patience. (Link to Caregiver Burnout Episode)
Caregiver
The primary person in charge of care of an Alzheimer patient, usually a family member or a designated health care professional.
Cerebellum
A fist-sized structure that coordinates movement and balance. Located at the base of the brain beneath the cerebral cortex.
Cerebral Cortex
The convoluted outer layer of gray matter that constitutes the "thinking" portion of the brain.
Cholinesterase Inhibitors
Medications that slow the breakdown of acetylcholine. Used in the treatment of Alzheimer's disease.
Cognitive Reserve
The theory of "cognitive reserve" says that it's possible to develop a "stockpile" of mental abilities that can help ward off the effects of Alzheimer's disease and other physical conditions that affect brain functions.
Cognitive
Brain processes such as thinking, attention, perception, learning, memory, reasoning, problem solving, decision-making and planning. Cognitive processes are distinguished from emotional processes (feelings) and behavioral processes (actions).
Competence
A person's ability to make informed choices.
Consolidation
In terms of memory, consolidation is the second step in forming memories and refers to the process of moving the information from short-term to long-term memory; this can take several weeks or even months.
Continuum of Care
Care services available to assist individuals throughout the course of the disease.
Cueing
The process of providing cues, prompts, hints, and other meaningful information, direction, or instruction to aid a person who is experiencing memory difficulties.
Declarative or Explicit Memory
This is information that you deliberately work at remembering (or memorize), and that you can describe in words, such as the names of the presidents or the meanings of words.
Deficits
Physical and/or cognitive skills or abilities that a person has lost, has difficulty with, or can no longer perform due to his or her dementia.
Delusion
False belief firmly held by a person even though others recognize the belief to be clearly untrue. Delusions can occur among those with Alzheimer's disease and other kinds of dementia.
Dementia
Significant loss of intellectual abilities such as memory capacity, severe enough to interfere with daily life. The symptoms of dementia can include changes in personality, mood and behavior. Disease and injury cause irreversible dementia. But dementia caused by drugs, alcohol, hormone imbalances, vitamin deficiencies or depression may be reversible.
Differential Diagnosis
The determination of which of two or more diseases with similar symptoms is the one from which the patient is suffering, by a systematic comparison and contrasting of the clinical findings.
Do Not Resuscitate (DNR) Order
A DNR order tells the health care facility or doctor not to revive a patient whose heart or breathing has stopped. A DNR order requires the signature of the person or a substitute (see Advance directive).
Functional Impairment
Functional impairment means being unable to dress, use the toilet, eat, bathe or walk without help.
Geriatrics
The branch of medicine concerned with the diagnosis, treatment and prevention of disease in older people and the problems specific to aging.
Hallucination
A sensory experience that seems real to the person experiencing it, though it is not actually happening. Hallucinations can occur among those with Alzheimer's disease and other kinds of dementia.
Hippocampus
A small, "S"-shaped structure in the brain that appears to play a major role in the process of forging memories.
Immune System
The body's natural defense system against infection and disease. It consists of many organs and cells that have various specialized functions within the overall fight against antigens.
Long-term Memory
Information that was learned as recently as a few minutes ago and as long ago as early childhood.
Memory
The storage and retrieval of information. In order for memory to work properly, facts, experiences, and understandings must be stored properly before they can be accessed later. In Alzheimer's disease, some people have difficulty storing information; others have trouble retrieving it; still others cannot complete either task.
Memory is often divided into:
- Short-term memory -- refers to more recent events, experiences, and information
- Long-term memory -- deals with things from long ago
Alzheimer's disease tends to compromise short-term memory more significantly than long-term memory.
Memory can also be categorized as procedural (remembering how to do things), semantic (remembering concepts and meanings), and episodic (remembering experiences, such as where you left your purse or who your teacher was for freshman algebra).
Minor memory problems can be due to stress, distraction, or fatigue. More serious memory problems may signal a disease such as Alzheimer's.
Mild Cognitive Impairment (MCI)
Forgetfulness that is worse than normal for one's age but is not associated with certain cognitive problems common in dementia, such as disorientation or confusion. The severity of MCI falls between that of age-associated memory impairment and early dementia.
Mixed Dementia
A brain syndrome caused by more than one disease process. The most common mixed dementia is a combination of vascular dementia, where blood flow to the brain is compromised by a stroke or other circulatory condition, and Alzheimer's disease. While it's often assumed that a person's dementia has a singular cause, diagnosis is much more complex due to the high incidence of multiple medical conditions among older adults.
Neurofibrillary Tangles
Twisted, hair-like threads, composed mainly of the protein tau, which remains after the microtubules in the nerve cell collapse. Found in the brains of virtually all people with Alzheimer's disease.
Neuron
Nerve cell.
Neuro-psychology Testing
Assessment of brain functioning through structured and systematic behavioral observation. Neuropsychological tests are designed to examine a variety of cognitive abilities, including speed of information processing, attention, memory, language, and executive functions, which are necessary for goal-directed behavior.
Neurotransmitter
A specialized chemical that relays messages between nerve cells.
Non-declarative or Implicit Memory
Non-declarative or implicit memory is information you use to do something, such as drive a car or tie a tie.
Orientation
The state of a person's situational awareness. Extent of orientation is usually tested by asking questions such as:
- What is your name? Who are you?
- What country do you live in? State? City?
- Where are you?
- What day is it? Date? Season? Year?
Health care professionals often assess orientation as part of a larger diagnostic work-up for Alzheimer's. People in the early stages of the disease may be disoriented to place and/or time, but are still oriented to person. As the disease progresses, some lose orientation to person as well.
Paranoia
Suspicion of others that is not based on fact.
Perseveration
Persistent repetition of an activity, word, phrase, or movement, such as tapping, wiping, and picking.
PET Scan (Positron Emission Tomography)
A highly specialized imaging technique that uses short-lived radioactive substances to produce three-dimensional colored images of those substances functioning within the body. PET scanning provides information about the body's chemistry not available through other procedures. Unlike CT (computerized tomography) or MRI (magnetic resonance imaging), techniques that look at anatomy or body form, PET studies metabolic activity or body function. PET has been used primarily in cardiology, neurology, and oncology.
Power of Attorney
A legal form that names someone to act as your surrogate when you are no longer able to make decisions for yourself.
Pseudodementia
A condition that resembles dementia but is actually due to depression. In pseudodementia, a person may appear confused, exhibit depressive symptoms such as sleep disturbance, and complain of memory impairment and other cognitive problems. However, upon careful testing, memory and language functioning are intact. People with pseudodementia often respond to antidepressant medications.
Psychometric Tests
Psychometric tests are tools used to diagnose dementia and distinguish between "normal" memory loss and more serious forms; they consist of questions that explore a person's mental status and ability to think (cognitive skills).
Respite Care
Respite care provides temporary relief from caregiving tasks. Such care could include in-home assistance, a short nursing home stay or adult day care.
Semantic Memory
Semantic memory is information so deeply ingrained and used so often that virtually no effort is needed to remember it, such as the name of the current month.
Senility
Term meaning "old," once used to describe elderly diagnosed with dementia. Today, we know dementia is caused by various diseases (e.g., Alzheimer's) and is not a normal part of aging.
Short-term Memory
Also known as working memory. Sometimes equated with consciousness.
Sundowning
The onset or exacerbation of delirium during the evening or night with improvement or disappearance during the day; most often seen in mid and later stages of dementing disorders, such as Alzheimer disease.
Synapse
The junction where a signal is transmitted from the axon of one nerve cell to the dendrite of another nerve cell, usually by a neurotransmitter.
Vascular Dementia
Dementia resulting from blood vessel disease, typically from a series of tiny strokes.
Working Memory
Often used as a synonym for short-term memory, working memory refers to information that is briefly stored and quickly put to use. If it is not used quickly, or seems no longer useful, it rapidly fades from the memory.
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