Glossary of Terms

Glossary of Terms

Acetylcholine: A chemical produced in the brain (a neurotransmitter) that is involved in learning and memory. It transfers information signals from one nerve cell to the next. Acetylcholine is greatly diminished in the brains of people with Alzheimer’s disease.

Activities of Daily Living (ADLs): Activities necessary for everyday living and functioning, such as eating, bathing, grooming, dressing, and toileting.

Aggression: Hitting, pushing, or threatening behavior that may occur with daily activities or for no apparent unmet need.

Agitation: A term that encompasses a host of disturbed or disturbing behaviors which include inappropriate verbal, vocal, or motor activities that may or may not be aimed at others.

Agnosia: Perceptual difficulties where there is a loss or reduced ability to recognize objects, places, and people.

Alzheimer’s Disease (AD): The most common dementia, AD is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior. AD is defined by a presence of a memory disorder plus one or more of the following: agnosia (perceptual disorder), aphasia (language disorder), apraxia (disorder of voluntary movements), and impairment of judgment, decision making and social appropriateness.

Amino acids: The building blocks of proteins; simple, organic compounds containing carbon, nitrogen, oxygen, and hydrogen.

Amnesia: In Alzheimer’s disease, amnesia is a clinically significant memory deficit where there is a dramatic inability to learn new information, a deficit that is not corrected by cueing or recognition.

Amyloid: A protein deposit associated with tissue damage and breakdown. Amyloid is found in the brains of individuals with Alzheimer’s disease.

Amyloid Plaque: Abnormal clusters of dead and dying nerve cells, other brain cells, and amyloid protein fragments.

Antioxidants: Chemicals used to combine with and disarm free radicals, the free or loose neurons that can combine with and impair the function of important molecules, creating the characteristic changes of aging seen in skin, tendon, bone cartilage and connective tissue.

Anxiety: A feeling of apprehension, fear, nervousness, or dread accompanied by restlessness or tension.

Apathy: A mood state that is characterized by indifference or lack of persistence in an activity; Lack of interest, concern, or emotion.

Aphasia: A focal cognitive deficit where there is difficulty understanding the speech of others (receptive aphasia) and/or expressing oneself verbally (expressive aphasia). Impairment of language may be manifested by difficulty in word finding (dysnomia) and object naming (anomia) with resultant word substitutions (paraphasias).

Apraxia: Includes disorders of complex skilled movements such as driving a car, preparing food, dressing, or feeding oneself

Atherosclerosis:  Hardening and narrowing of the body’s arteries caused by formation of plaque and chronic inflammation. Plaques are partially made up of certain types of fats including cholesterol and triglycerides. Atherosclerosis can lead to stroke, heart attack, eye problems, and kidney problems.

Attention: is the ability to focus

Beta-amyloid: Protein that builds up on nerve cells that cause them not to work well

Bruxism: clench or grind your teeth

Cerebral Cortex: The outer layer of the brain, consisting of nerve cells and the pathways that connect them. The cerebral cortex is the part of the brain in which thought processes take place.

Cholinesterase: An enzyme that breaks down acetylcholine into active parts that can be recycled. This depletes the acetylcholine available to carry message signals between nerve cells.

Chronic Obstructive Pulmonary Disease (COPD): effects the lungs and makes it difficult for the person to take a full breath. When a person is chewing and swallowing, they are not taking breaths. When a person has a choice between breathing and eating, the person will choose to breath.

Cognitive: Pertaining to the mental process of knowing, including awareness, perception, reasoning, and judgment.

Computed (Axial) Tomography (CAT or CT) Scan: A technique in which multiple X-rays of the body are taken from different angles in a very short period of time. These images are collected by a computer to give a series of images that look like “slices” of the body. In diagnosing dementia, CT scans can reveal tumors and small strokes in the brain.

Concentration: is the ability to stay focused for longer periods of time

Congestive Heart Failure (CHF): allows the person’s body to fill with additional fluid, called edema. The person feels full due to the additional fluid and doesn’t want to eat.

Constipation: abnormally delayed or infrequent passage of dry hardened feces.

Creutzfeldt-Jakob Disease (CJD): CJD is a rare, fatal brain disorder caused by a transmissible infectious organism, called a prion. Symptoms include failing memory, change in behavior, and a lack of coordination. Like Alzheimer’s disease, a definitive diagnosis can be obtained only through an examination of brain tissue usually at autopsy.

Chromosomes:  Structures containing genetic material (DNA) in the nucleus of a cell.  Human cells other than sperm and eggs have 46 paired chromosomes.

Delirium: A state of mental confusion characterized by disorientation, and which may include delusions and hallucinations, and incoherent speech. The condition may be caused by fever, shock, exhaustion, anxiety or drug overdose and is reversible if the cause can be determined and treated.

Delusion: A false idea that is firmly believed and strongly maintained in spite of contradictory proof or evidence.

Dementia: An overall term referring to the various diseases, such as Alzheimer’s disease, that cause a loss of mental functions. It is an acquired, persistent impairment in multiple areas of intellectual function not due to delirium. There is a compromise in three or more of the following nine spheres of mental activity: memory, language, perception, praxis (skills), calculations, conceptual or language knowledge, executive or decision making functions, personality or social behavior, and emotional awareness or expression.

Depression: The most common psychiatric disorder among older people, it can vary in duration and degree and show psychological as well as physiological manifestations. Characteristics include sadness, inactivity, insomnia, difficulty in thinking and concentration, feelings of hopelessness, and sometimes suicidal tendencies.

Disinhibition:  This refers to the inability or reduced capacity to control or inhibit an impulsive response. Persons with dementia may be less able to monitor or self-regulate behaviors due to neurological deterioration that comes with the illness. Disinhibition may take the form of verbally or physically aggressive behaviors, sexual aggressiveness, or socially unacceptable acts.

Electroencephalography (EEG):  A measurement of the electrical activity of the brain by recording from electrodes placed on the scalp. In rare cases, the electrical activity is recorded directly from the surface of the brain.

Esophagus: the tube in our bodies that connects the mouth to the stomach

Executive Function: Deals with strategic planning and follow-through. They include the ability to formulate long-term goals, the steps and program to meet those goals, the motivation to act on those steps, and the ability to monitor and reassess progress in attaining those goals.

Frontal Lobe: The top, front regions of each of the cerebral hemispheres. They are used for reasoning, emotions, judgment, impulse control and voluntary movement.

Fronto-Temporal Dementia (FTD): A form of dementia (Pick’s disease is an example) characterized by early damage to the frontal brain that monitors judgment and controls impulses. FTD is noted for extreme behavior difficulties as well as speech impairment. Memory may not be affected until later in the illness. Other characteristics include poor judgment, social and interpersonal conduct problems, and apathy.

Global Deterioration Scale (GDS): The scale has 7 stages

  • Stage 1: No cognitive impairment and memory problems are undetected by examinations
  • Stage 2: Very mild cognitive decline (e.g., losing keys, forgetting names)
  • Stage 3: Mild cognitive decline (early AD) (e.g., friends and family notice change in memory)
  • Stage 4: Moderate cognitive decline (early AD), (e.g., unable to manage finance, impaired memory of the past)
  • Stage 5: Moderately severe cognitive decline (e.g., unable to recall date, unable to select clothing, assistance with toileting)
  • Stage 6: Severe cognitive decline (e.g., unaware of surroundings, personality/behavior changes, help with toileting)
  • Stage 7: Final stage (e.g., lose ability to speak, unable to sit or smile)

Hallucinations: False perceptions or reports of sensory impressions that cannot be consensually validated; A sensory experience in which a person sees, hears, smells, tastes, or feels something that is not there.

Heartburn: A burning discomfort behind the lower part of the sternum usually related to irritation of the lower end of the esophagus or upper part of the stomach often in association with regurgitation or reflux from the stomach into the esophagus.

Hippocampus: A structure deep within the brain that processes memory and emotion.

HIV or AIDS dementia complex: This is one of the most common brain complications of late HIV-1 infection. Depending on the severity, it causes three categories of dysfunction: cognitive, motor, and behavioral. Psychosis may also be a symptom.

Hospice: A concept of care for the terminally ill that provides psychological, social, and spiritual services when needed by the patient and /or family members on a 24-hour, seven-day-a-week basis.

Hypertension: High blood pressure.

Huntington’s Disease: An inherited, degenerative brain disease which affects the mind and body. The disease usually begins during mid-life and is characterized by intellectual decline, and irregular and involuntary movements of the limbs or facial muscles. Personality changes and memory disturbances are also characteristic of the disease.

Illusions: A mistaken perception: mistaking one thing for something else because of a real or imagined resemblance, such as mistaking a hat rack for a person.
Incontinence: Loss of bladder and/or bowel control.

Instrumental Activities of Daily Living (IADLS): Includes both the personal self-care activities as well as more complex activities, such as going shopping or doing housework. Because the IADL tasks are more complicated and multifaceted, functional losses are expected to show up first in these items.

Lewy Body Dementia: A form of dementia identified by inclusions in parts of the brain responsible for memory and motor control. These inclusions are also seen in Parkinson’s disease. Tremor, rigidity and lack of spontaneous movement are seen in both conditions.

Lumbar puncture:  A procedure to sample cerebral spinal fluid (CSF), which is the fluid that surrounds the brain and spinal cord. The sample is usually taken from the spine along the lower back after the patient receives medication to relieve pain during the procedure.

Magnetic Resonance Imaging (MRI): A high-resolution structural imaging technique that allows for the visualization of brain anatomy with a high degree of contrast between brain tissue types.

Malnutrition: lack of the minimum amount of fluids, proteins, carbohydrates, lipids, vitamins, minerals and other nutrients essential for sound health and growth.

Memory: Memory has multiple dimensions. These include primary memory (short-term memory), working memory (manipulation of primary memory), secondary memory (new learning or recent memory), and tertiary memory (retrieval of remote information).

Mild Cognitive Impairment (MCI): Described as poor performance on mental status exam but with normal functional ability. MCI includes memory complaints which are not accompanied by other impairments seen in dementia.

Mini-Mental State Examination (MMSE): A popular 30-item instrument (developed by Drs. Folstein, Folstein and McHugh) that evaluates orientation, registration of information, attention and calculations, recall, language, and visual constructions. A total score of 23 or less suggests the presence of dementia or other mental status impairment.

Neurofibrillary Tangle: An accumulation of twisted protein fragments inside nerve cells. Neurofibrillary tangles are one of the characteristic structural abnormalities found in the brains of people with Alzheimer’s disease.

Occipital Lobe: This region of the brain is behind each cerebral hemisphere and contains the centers of vision, recognition, and reading ability located at the back of the head.

Osteoarthritis: A demineralization of bone often associated with aging.

Oxidation:  A chemical reaction of a substance with oxygen (O2) or an oxygen-containing material, which adds oxygen atom(s) to the substance.

Oxidative stress: Occurs when there is an overproduction of reactive oxygen molecules relative to the body’s ability to detoxify the reactive molecules or repair the damage caused by them. Oxidative stress can occur with the production of toxic free radicals in the course of normal metabolism.  The body requires defenses against oxidative stress in order to remain healthy.  Oxidative stress is involved in many diseases such as Alzheimer’s disease, Parkinson’s disease, and atherosclerosis.

Palliative Care: Care directed at symptom control rather than cure. The term is often used synonymously with hospice care.

Paranoia: Suspicion and fear of someone else that is not based on fact.

Parietal Lobe: The middle lobe of each cerebral hemisphere between the frontal and occipital lobes. Here sensations are received including the sense of where one is in space, where reading and writing is initiated, and where automatic motor actions are planned.

Parkinson’s Disease (PD): A progressive disorder of the central nervous system affecting motor control. Individuals with PD lack the neurotransmitter dopamine, which is important for the central nervous system’s control of muscle activity. PD is characterized by tremors, stiffness in limbs and joints, speech impediments and difficulty in initiating physical movement.

Perception: Processes that enable an individual to acquire and interpret information
from the environment.

Pick’s disease (frontotemporal dementia): A rare disorder that damages cells in the frontal and temporal lobes of the brain. Although it typically affects people in their 50s and 60s, it has been diagnosed in people from the ages of 20 to 80. Behavior and personality changes usually precede memory loss and language problems.

Pocketing: Holding food in the mouth

Retrogenesis: Developmental reversal; this concept means that a person loses skills such as walking, speaking, self-feeding, and driving a car in roughly the reverse order they learned these skills as a child into adulthood.

Restraints: Devices used to restrict and/or control a person’s movement.

Safe Return®: The Alzheimer’s Association’s nationwide identification, support, and registration program that assists in the safe return of individuals with Alzheimer’s disease or related dementia who wander and become lost.

Saliva: liquid in the mouth that helps keep the mouth wet and helps soften food we put in our mouth to eat. The fluid starts the food to be digested.

Semantic Memory: Processes whereby individuals access general information such as words, concepts, and facts, independent of context.

Sundowning: Unsettled behavior evident in the late afternoon or early evening.

Tau protein:  Proteins within the cell that help to stabilize and assemble microtubules, which are structures within the cell that act like tracks along which cellular components can travel from one part of the cell to another. Tau proteins are abundant in nerve cells within the brain and are less common elsewhere. In Alzheimer’s disease, tau proteins become hyper- phosphorylated, which makes them “sticky” to form neurofibrillary tangles.

Temporal Lobe: The region at the lower side of each cerebral hemisphere that contains centers of hearing and memory for words.

Transient Ischemic Attack (TIA): A small stroke that may signal the onset of a more substantial stroke.

Vascular Dementia: A form of dementia that results from various types of injury to the blood vessels of the brain, such as stroke and is associated with high blood pressure, high cholesterol and diabetes.

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