Kuliah Lansia Blok 20 2009

8/12/2019 Kuliah Lansia Blok 20 2009

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Perkembangan mental dewasa & usia lanjut

Adnil EdwinNurdin


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BEHAVIORAL GROWTH AND DEVELOPMENT

Erik Erikson Epigenetic Principle

Development occurs in sequential, clearly defined stages

Specific issue in each stage

Issues in each stage must be resolved

Development can proceed smoothly

Successful resolution failed in a particular stage

All subsequent stages reflect that failure

Maladjustment of:

Physical growthCognitive development

Social development

Emotional development


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Stages

1.Basic Trust versus Mistrust (birth-1 year)

Need for instant satisfaction, TRUE LOVE

Resolved-----Strong Basic trust, believe in others, hopeful attitude, self

confidence, trustful personality

Unresolved-------suspicious, cant control urge

2.Autonomy versus Shame and Doubt (1-3 years) learning to walk, feed it self, talk, TOILET TRAINING

need for firm outer control, first discipline, in love----autonomy

to much outer control------shame

to much punishment, harsh discipline----self doubt

3.Initiative versus Guilt (3-5 years)

initiative arises in relation to tasks for the sake of activity

guilt arises on contemplated goal

mimic adult world

sibling rivalry

resolution through social role identification

I am a boy, she is a girl. I play with a toy gun, she plays with a doll


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Stages (cont)

6.Intimacy versus Isolation (21-40 years)

to love, to work, to nurture others, to be responsible for others

resolved-----intimacy, loyalty, responsible, loving

unresolved---isolation, view that others are dangerous

7.Generativity versus Stagnation (40-65 years)work for the future generation, productive, creativity, concern and responsibility

for others, striving to left some thing good for future generation after death---

GENERATIVITY

Unresolved-----self concern, isolated

8.Integrity versus Despair (more than 65 years)

Integrity---sense of satisfaction that life has been productive and worthwhile-----I

WILL SLEEP IN PEACE, AND IF THE TIME CAME, I HAVE LEFT SOMETHING USEFUL

FOR POSTERITY. THANKS GOD FOR THIS LIFE

Despair----what have I done in the past---FEARFUL OF DEATH


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Conclusion

1.Growth and development occur in stages

2.Each stage has its own specific issues which must be resolved

3.Unresolved issues in certain stage will hamper the next stages

4.Growth and development failure

POST POWER SYNDROME ?PERSONALITY MEMANG SUDAH TERGANGGU


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WHAT ARE THE BIOLOGICAL BASE OF AGING?

Memory in normal aging vs Alzheimer

memory loss, hallmark Alzheimer's disease.

memory loss normalaging diff. Alzheimer's

Mild cognitive impairment (MCI)

transitional state

cognitive changesof normal agingAlzheimer's disease

MCI risk factor Alzheimers disease.

55% MCI Alzheimer dalam 4.5 tahun

HIPOKAMPUS
http://en.wikipedia.org/wiki/Memory_losshttp://en.wikipedia.org/wiki/Alzheimer%27s_diseasehttp://en.wikipedia.org/wiki/Aginghttp://en.wikipedia.org/wiki/Alzheimer%27s_diseasehttp://en.wikipedia.org/wiki/Alzheimer%27s_diseasehttp://en.wikipedia.org/wiki/Aginghttp://en.wikipedia.org/wiki/Alzheimer%27s_diseasehttp://en.wikipedia.org/wiki/Memory_loss


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Memory decline in normal aging

ability to encode new memories of events or facts

working memory

episodic memory

impairments in the ability to refresh recently processed information

remembering the source of information

declines in the ability to bind information together
http://en.wikipedia.org/wiki/Working_memoryhttp://en.wikipedia.org/wiki/Episodic_memoryhttp://en.wikipedia.org/wiki/Episodic_memoryhttp://en.wikipedia.org/wiki/Working_memory


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Domains of memory mostly spared in normal aging

procedural memory

short-term memory

semantic knowledge, such as vocabulary, improves with age

enhancement in memoryfor emotional events

Retrospective versus prospective memory

prospective memorynaturalistic contexts >

retrospective


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Qualitative changes

brain imaging use both hemispheres when completing memory tasksstrategiberubah

positivity effectwhen remembering information

increased focus on regulating emotion

preferential looking toward happy and away from sad
http://en.wikipedia.org/wiki/Positivity_effecthttp://en.wikipedia.org/wiki/Positivity_effect


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ALZHEIMER

neurodegenerative disease

Progressive cognitive deterioration

Declining activities of daily living

Neuropsychiatricsymptoms or behavioral changes

Most common type of dementia
http://en.wikipedia.org/wiki/Neurodegenerative_diseasehttp://en.wikipedia.org/wiki/Neuropsychologyhttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Dementiahttp://en.wikipedia.org/wiki/Neuropsychologyhttp://en.wikipedia.org/wiki/Neurodegenerative_disease


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Gradual symptoms

1 st.loss of short term memory (amnesia)

minor forgetfulness

steadily more pronounced

relative preservation of older memories.

cognitive (intellectual) impairment

language (aphasia)

skilled movements (apraxia),

recognition (agnosia),

decision-makingand planning closely related to the frontal and temporal lobes

disconnected from the limbic system, disease where the victims suffer the loss of qualities that define human

existence.
http://en.wikipedia.org/wiki/Amnesiahttp://en.wikipedia.org/wiki/Aphasiahttp://en.wikipedia.org/wiki/Apraxiahttp://en.wikipedia.org/wiki/Agnosiahttp://en.wikipedia.org/wiki/Decision-makinghttp://en.wikipedia.org/wiki/Limbic_systemhttp://en.wikipedia.org/wiki/Limbic_systemhttp://en.wikipedia.org/wiki/Decision-makinghttp://en.wikipedia.org/wiki/Decision-makinghttp://en.wikipedia.org/wiki/Decision-makinghttp://en.wikipedia.org/wiki/Agnosiahttp://en.wikipedia.org/wiki/Apraxiahttp://en.wikipedia.org/wiki/Aphasiahttp://en.wikipedia.org/wiki/Amnesia


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Patobiologi

neuronalloss/atrophy, in the temporoparietal and frontal cortex

inflammatory response to amyloid plaquesand neurofibrillary tangles.

Mutasi 3 gen familial, early-onset AD.

mutasi ApoE4 late onset AD
http://en.wikipedia.org/wiki/Neuronhttp://en.wikipedia.org/wiki/Atrophyhttp://en.wikipedia.org/wiki/Amyloidhttp://en.wikipedia.org/wiki/Neurofibrillary_tangleshttp://en.wikipedia.org/wiki/Familial_Alzheimer_diseasehttp://en.wikipedia.org/wiki/Apolipoprotein_Ehttp://en.wikipedia.org/wiki/Apolipoprotein_Ehttp://en.wikipedia.org/wiki/Familial_Alzheimer_diseasehttp://en.wikipedia.org/wiki/Familial_Alzheimer_diseasehttp://en.wikipedia.org/wiki/Familial_Alzheimer_diseasehttp://en.wikipedia.org/wiki/Neurofibrillary_tangleshttp://en.wikipedia.org/wiki/Amyloidhttp://en.wikipedia.org/wiki/Atrophyhttp://en.wikipedia.org/wiki/Neuron


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Neuropathology

Anatomigross diffuse atrophy of the brain loss of neurons, dendrit dan synap di cerebral cortex

subcortical regions.

gross atrophy

degenerasi temporal lobe, parietal lobe,frontal cortex,cingulate gyrus.

acetylcholine, serotonin, norepinephrine, somatostatinme
http://en.wikipedia.org/wiki/Cerebral_cortexhttp://en.wikipedia.org/wiki/Atrophyhttp://en.wikipedia.org/wiki/Temporal_lobehttp://en.wikipedia.org/wiki/Parietal_lobehttp://en.wikipedia.org/wiki/Frontal_cortexhttp://en.wikipedia.org/wiki/Cingulate_gyrushttp://en.wikipedia.org/wiki/Acetylcholinehttp://en.wikipedia.org/wiki/Serotoninhttp://en.wikipedia.org/wiki/Norepinephrinehttp://en.wikipedia.org/wiki/Somatostatinhttp://en.wikipedia.org/wiki/Glutamatehttp://en.wikipedia.org/wiki/Glutamatehttp://en.wikipedia.org/wiki/Somatostatinhttp://en.wikipedia.org/wiki/Norepinephrinehttp://en.wikipedia.org/wiki/Serotoninhttp://en.wikipedia.org/wiki/Acetylcholinehttp://en.wikipedia.org/wiki/Cingulate_gyrushttp://en.wikipedia.org/wiki/Frontal_cortexhttp://en.wikipedia.org/wiki/Parietal_lobehttp://en.wikipedia.org/wiki/Temporal_lobehttp://en.wikipedia.org/wiki/Atrophyhttp://en.wikipedia.org/wiki/Cerebral_cortex


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Risk reducers

Intellectual stimulation, catur, bridge, crossword

Regular physical exercise

Regular social interaction

A generally healthy diet low in saturated fat, supplemented in

particular with:

B vitamins

Omega-3 fatty acids, especially Docosahexaenoic acid

Fruit and vegetable juice
http://en.wikipedia.org/wiki/B_vitaminshttp://en.wikipedia.org/wiki/Omega-3_fatty_acidshttp://en.wikipedia.org/wiki/Docosahexaenoic_acidhttp://en.wikipedia.org/wiki/Docosahexaenoic_acidhttp://en.wikipedia.org/wiki/Omega-3_fatty_acidshttp://en.wikipedia.org/wiki/Omega-3_fatty_acidshttp://en.wikipedia.org/wiki/Omega-3_fatty_acidshttp://en.wikipedia.org/wiki/B_vitamins


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Kuliah Lansia Blok 20 2009

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