CFG Aging Process & Psychological Aspects 4 — Questions and Answers
Question 1: Which of the following best describes 'sundowning' observed in some older adults with dementia?
- A structured evening routine that reduces dementia-related anxiety
- Increased confusion, agitation, and behavioral disturbance occurring in the late afternoon or evening (Correct answer)
- Daytime sleepiness caused by nighttime pain medications
- A gradual and permanent decline in orientation to time
Correct answer: Increased confusion, agitation, and behavioral disturbance occurring in the late afternoon or evening
Sundowning syndrome refers to the exacerbation of neuropsychiatric symptoms in dementia patients during late afternoon and evening hours.
Question 2: The five-stage grief model proposed by Elisabeth Kübler-Ross was originally developed through research on:
- Bereaved spouses in long-term marriages
- Terminally ill patients facing their own deaths (Correct answer)
- Survivors of sudden traumatic loss
- Older adults in nursing facility placement
Correct answer: Terminally ill patients facing their own deaths
Kübler-Ross developed her denial-anger-bargaining-depression-acceptance model from interviews with terminally ill hospital patients, not bereaved survivors.
Question 3: Complicated grief (prolonged grief disorder) differs from normal bereavement primarily by:
- Occurring in people without prior history of depression
- Persistent intense yearning and inability to accept the loss beyond 12 months (Correct answer)
- Absence of crying or visible sadness in the weeks after loss
- Immediate return to baseline functioning within 30 days
Correct answer: Persistent intense yearning and inability to accept the loss beyond 12 months
Prolonged grief disorder is characterized by debilitating grief symptoms — especially yearning and difficulty accepting the death — that persist beyond expected adjustment periods.
Question 4: An older adult rates her life as highly satisfying despite chronic pain and limited mobility. This phenomenon is known as:
- Denial and avoidance coping
- The disability paradox or adaptation level effect (Correct answer)
- Positive illusion bias
- Affective forecasting error
Correct answer: The disability paradox or adaptation level effect
The disability paradox describes how people with severe disabilities often report high quality of life because they adapt their internal standards and comparison points over time.
Question 5: Which neurological change is considered a NORMAL part of brain aging (not indicative of dementia)?
- Significant hippocampal atrophy causing episodic memory loss
- Formation of amyloid plaques sufficient to impair daily function
- Modest reduction in processing speed and prefrontal cortex volume (Correct answer)
- Loss of semantic memory for overlearned facts
Correct answer: Modest reduction in processing speed and prefrontal cortex volume
Normal aging involves mild reduction in white matter integrity and prefrontal function affecting processing speed, but not the widespread pathological changes seen in dementia.
Question 6: A financial gerontologist is screening a new 78-year-old client. Which instrument is commonly used to briefly assess cognitive function in this population?
- Beck Depression Inventory-II (BDI-II)
- Montreal Cognitive Assessment (MoCA) (Correct answer)
- Geriatric Depression Scale-15 (GDS-15)
- Mini Nutritional Assessment (MNA)
Correct answer: Montreal Cognitive Assessment (MoCA)
The MoCA is a widely used 30-point brief cognitive screening tool sensitive to mild cognitive impairment, commonly used in geriatric and financial capacity assessments.
Question 7: The concept of 'age-related financial vulnerability' is MOST associated with which combination of factors?
- High income and complex investment portfolios
- Cognitive decline, social isolation, and emotional regulation changes (Correct answer)
- Retirement status and reduced physical activity
- Living alone and low educational attainment exclusively
Correct answer: Cognitive decline, social isolation, and emotional regulation changes
Research identifies cognitive changes impairing judgment, loneliness increasing susceptibility to social influence, and altered emotional processing as the triad driving financial exploitation risk.
CFG Aging Process & Psychological Aspects 4
Which of the following best describes 'sundowning' observed in some older adults with dementia?