Aging is a natural process in the life cycle. When all systems are functioning and well balanced, the individual is likely to maintain a satisfying existence. Every day is filled with a positive outlook and sense of wonder. When the balance is tipped, as a result of failing health, family or housing difficulties, increasing physical limitations, or emotional distress, facing each day becomes painful.
The Creative Arts Therapies are life-enhancing. The goal of engagement with the arts—art, music, drama and dance/movement—involves participation in a creative process that stimulates the brain and encourages presence of mind. Active exploration with the arts promotes emotional and physical well-being and provides opportunities to problem-solve, explore and reflect in new ways.
ITA works with mature adults in hospitals, nursing facilities, and on-site at our Evanston location, both individually and in groups. We strive to achieve significant improvements in our clients’ quality of life physically, socially, communicatively and emotionally.
Diagnoses for the Elderly:
From the DSM-5:
Dementia: ‘Although dementia is the customary term for disorders like the degenerative dementias that usually affect older adults, the term neurocognitive disorder is widely used and often preferred for conditions affecting younger individuals, such as impairment secondary to traumatic brain injury or HIV infection.’
Alzheimer’s Disease: ‘…the core features of major or mild [neurocognitive disorders] NCD due to Alzheimer’s disease include an insidious onset and gradual progression of cognitive and behavioral symptoms. The typical presentation is amnestic (i.e., with impairment in memory and learning). Unusual nonamnestic presentations, particularly visuospatial and logopenic aphasic variants, also exist. At the mild NCD phase, Alzheimer’s disease manifests typically with impairment in memory and learning, sometimes accompanied by deficits in executive function. At the major NCD phase, visuoconstructional/perceptual motor ability and language will also be impaired, particularly when the NCD is moderate to severe. Social cognition tends to be preserved until late in the course of the disease.’
Parkinson’s Disease: ‘The essential feature of major or mild neurocognitive disorder (NCD) due to Parkinson’s disease is cognitive decline following the onset of Parkinson’s disease. The disturbance must occur in the setting of established Parkinson’s disease, and deficits must have developed gradually.’
Huntington’s Disease: ‘Progressive cognitive impairment is a core feature of Huntington’s disease, with early changes in executive function (i.e., processing speed, organization, and planning) rather than learning and memory… A diagnosis of definite Huntington’s disease is given in the presence of unequivocal, extrapyramidal motor abnormalities in an individual with either a family history of Huntington’s disease or genetic testing showing a COG trinucleotide repeat expansion in the HTT gene, located on chromosome 4.’
Lewy Bodies Dementia: ‘Major or mild neurocognitive disorder with Lewy bodies (NCDLB), in the case of major neurocognitive disorder (NCD), corresponds to the condition known as dementia with Lewy bodies (DLB). The disorder includes not only progressive cognitive impairment (with early changes in complex attention and executive function rather than learning and memory) but also recurrent complex visual hallucinations; and concurrent symptoms of rapid eye movement (REM) sleep behavior disorder (which can be a very early manifestation); as well as hallucinations in other sensory modalities, depression, and delusions.’
Frontotemporal Dementia: ‘Major or mild frontotemporal neurocognitive disorder (NCD) comprises a number of syndromic variants characterized by the progressive development of behavioral and personality change and/or language impairment. The behavioral variant and three language variants (semantic, agrammatic/nonfluent, and logopenic) exhibit distinct patterns of brain atrophy and some distinctive neuropathology. The criteria must be met for either the behavioral or the language variant to make the diagnosis, but many individuals present with features of both.’
Vascular Dementia: ‘The diagnosis of major or mild vascular neurocognitive disorder (NCD) requires the establishment of an NCD and the determination that cerebrovascular disease is the dominant if not exclusive pathology that accounts for the cognitive deficits. Vascular etiology may range from large vessel stroke to microvascular disease; the presentation is therefore very heterogeneous, stemming from the types of vascular lesions and their extent and location. The lesions may be focal, multifocal, or diffuse and occur in various combinations.’
Prion Disease: ‘The classification of major or mild neurocognitive disorder (NCD) due to prion disease includes NCDs due to a group of subacute spongiform encephalopathies (including Creutzfeldt-Jakob Disease, variant Creutzfeldt-Jakob Disease, kuru, Gerstmann-Sträussler-Scheinker syndrome, and fatal insomnia) caused by transmissible agents known as prions. The most common type of sporadic Creutzfeldt-Jakob disease, typically referred to as CJD. Variant CJD is much rarer and is associated with transmission of bovine spongiform encephalopathy, also called, ‘mad cow disease.’ Typically, individuals with CJD present with neurocognitive deficits, ataxia, and abnormal movement such as myoclonus, chorea. or dystonia; a startle reflex is common. Typically, the history reveal rapid progression to major NCD over as little as 6 months, and thus the disorder is typically seen only at the major level. However, many individuals with the disorder may have atypical presentations, and the disease can be confirmed only by biopsy or at autopsy. Individuals with variant CJD may present with a greater preponderance of psychiatric symptoms, characterized a by low mood, withdrawal, and anxiety. Prion disease is typically not diagnosed without at least one of the characteristic biomarker features: recognized lesions on magnetic resonance imaging with DWI (diffusion-weighted imaging) or FLAIR (fluid-attenuated inversion recovery), tau or 14-3-3 protein in cerebrospinal fluid, characteristic triphasic waves on electroencephalogram, or, for rare familial forms, family history or genetic testing.’
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Neurocognitive Disorders (591, 611-638). Arlington, VA, American Psychiatric Association, 2013.
Learn more about Dementia here.
Disclaimer: Due to the nature of this post, this information is meant to be informative and not serve as a diagnosis for dementia and other neurocognitive disorders. If you believe you or someone you know needs help with one of the disorders listed above, please seek out a doctor or professional for a proper diagnosis.