6. Major and minor neurocognitive disorders (Dementia): etiology, diagnostic criteria, and clinical management Flashcards
Neurocognitive disorder def
a group of conditions defined by a decline from a previous level of cognitive functioning.
six cognitive domains that may be affected in neurocognitive disorders
1) Complex attention
*
2) Executive function
*
3) Learning and memory
4) Language
*
5) Perceptual-motor skills
*
6) Social cognition (interaction
The DSM-5 divides the NCDs into
three main categories:
* delirium,
* minor NCDs, and
* major NCDs (dementia).
Minor NCDs
individuals with mild cognitive impairment.
These individuals have trouble with some of the more complex activities of living but are able to maintain their independence
Major NCDs
: these individuals require assistance with independent activities of daily living (e.g., paying bills, managing medications, or shopping for groceries).
Over time, the basic activities of daily living (e.g., feeding, toileting, and bathing) are affected, eventually leading to total dependence.
The dementias are —- and —–
progressive and irreversible major NCDs that primarily affect the elderly.
what is dementia
Dementia is not a disease,
but rather a set of symptoms comprising poor memory, and difficulties with learning and language.
dementia dsm5
name other major NCDs present similarly to the dementias, but their progression may be arrested or even reversed with treatment
- vitamin B12 deficiency,
- thyroid dysfunction)
Pseudodementia def
- symptoms of major depression in the elderly often include problems with memory, concentration, and cognitive functioning.
- Because this clinical picture may be mistaken for a major NCD (dementia), it is termed pseudodementia; the presence of apparent cognitive deficits in patients with major depression.
Diagnosis dementia
- Mini Mental State Exam (MMSE):
*Assess orientation, attention/concentration, language, constructional ability, immediate and delayed recall - Mini-Cog: item recall (3 items) and clock-drawing tasks
Mini Mental State Exam (MMSE is sensitive for which NCDs
Sensitive for major NCDs (dementias), particularly moderate-to-severe forms
Maximal score: 30,
dysfunctional score: < 25
etiology of dementia
- Alzheimer’s disease (most common)
- Vascular dementia
- Lewy body dementia
- Frontotemporal dementia
- Prion disease
- Normal pressure hydrocephalus
- HIV infection
Alzheimer’s disease characteristics
Gradual progressive decline in cognitive functions; primary domains affected are memory, learning, and language
etiology of alzheimers
Accumulation of
* extra-neuronal beta-amyloid plaques and
* intra-neuronal tau protein tangles
→ result in brain atrophy
Alzheimer’s disease types
o Sporadic type: 95%
▪Late onset
▪Genetic and environmental factors
o Familial type:
▪Early onset
▪Dominant gene