Chapter 12 Neurocognitive Flashcards
Neurocognitive disorders can come from
transient or permanent damage to brain
What can neurocognitive change
thinking process, memory, perception, and consciousness
also behavior and emotional functioning are commonly seen
What are some causes to a neurocognitive disorder
degenerative conditions, stroke, head trauma, and infection
also influenced by social and psychological factors
What does screening look like
-gathering background info
-conducting a mental status examination
-using psychological and neuropsychological tests and inventories to evaluate specific functions
What is the Glasgow coma scale
objectively measures consciousness
What is electroencephalograph
measure firing of neurons via electrodes to scalp
What is computerized axial tomography(CAT) scan
brain images produced from cross-sectional x rays
What is a magnetic resonance imaging (MRI)
produces images of brain using magnetic field
What is positron emission tomography(PET) scan
assesses glucose metabolism in brain
What is Single photon emission computed tomography(SPECT)
provides longer but less detailed images of metabolic activity
What is major neurocognitive disorder
Significant decline in
-one or more cognitive areas
Ability to meet daily living demands
Dementia
What is dementia
pervasive deterioration in cognition
memory impairment
gradual onset and continuing cognitive decline
What is a Minor neurocognitive Disorder
involves deficits in at least one major area, but to a lesser degree of severity
struggle with familiar tasks or use compensatory strategies to complete tasks
extra effort to maintain independence but overall independent functioning not compromised
can be earlier stage of major neurocognitive disorder
What is delirium
-Acute state of confusion characterized by disorientation and impaired attention
-rapid development over hours or days
-symptoms may be mild or severe
-psychotic symptoms may be present
-sick and elderly at increased risk
What is the etiology of neurocognitive disorder
-result from variety of medical conditions
-specific brain pathology is the primary biological factor for each condition, but other factors affect condition to affect the outcome
How does a Traumatic brain injury happen
wound or internal injury to the brain
1.7 million get one per year
severity duration and symptoms vary
What are the symptoms for TBI
headache, confusion, memory loss, attention deficits, fatigue, irritability, and changes in behavior
more significant tissue damage is associated with more impaired functioning
What is Chronic Traumatic Encephalopathy(CTE)
-progressive degenerative condition involving brain damage from multiple episodes of head trauma
- symptoms of depression, poor impulse control, and increase risk of dementia in later adulthood
What is a concussion
most common
alteration in brain functioning often caused by a blow to the head
What is a contusion
brain strikes the skull with sufficient force to cause bruising; involve tissue damage
What is a cerebral laceration
open head injury in which brain tissue is torn, pierced, or ruptured; damage is localized
What is a cognitive vascular disorder
can result from a one-time cardiovascular event (stroke) or insidious, ongoing disruptions to the cardiovascular system
majority begin with atherosclerosis
What is a stroke
sudden halting of blood flow to a portion of the brain leading to brain damage
What is an Ischemic Stroke
Stoke due to reduced blood supply caused by a. clot or sever narrowing of the arteries supplying blood to the brain(85% of strokes)
What is a Transient Ischemic Attack(TIA)
mini-stroke,
resulting from temporary blockage of arteries; no long term damage
What is a hemorrhagic stroke
involving leakage of blood into the brain
What are some facts about stroke
-fourth leading cause of death(137,000 per year)
-majority over 50
-cigarettes cause 1/4
What are some risks for strokes
hypertension, obesity, salt, saturated fats , limited physical activity, stress, binge drinking, and depression
Stroke survivors often require long-term care due
to physical and psychological symptoms that impair independent functioning
What happens if you receive left hemisphere damage
affects speech and language proficiency and physical movement of right half of body
What happens is you receive right hemisphere damage
impairs judgment and short term memory, increases impulsivity, affects visual-spatial skills
What happens to stroke survivors
frustrated and depressed by difficulties experienced
cognitive skills decline due to chronic or sporadic cardiovascular events affecting blood flow to the brain
uneven deterioration of intellectual activities
physical and cognitive symptoms may be impaired
What is a neurodegenerative disorder
declining brain due to atrophy and loss of neurons
Vary:
age of onset
skills of affected
course of disorder
What is Alzheimers
Dementia involving memory loss in cognitive and adaptive functioning
5 million Americans
6th leading cause of death
risk increases with age, can attack at 30,40, or 50
What are some characteristics of Alzheimer’s
-progressive decline in cognitive, physical, and social functioning
-early symptoms: memory dysfunction, irritability, cognitive impairment
-other symptoms: social withdrawal, depression, apathy, delusions, impulsive behaviors, neglect of personal hygiene
-no cure
What are some memory loss factors for Alzheimers
With age, neurons are gradually lost, the brain becomes smaller, and info is processed more slowly(normal process)
many adults experience minimal decline because with age, the brain reorganizes itself
acute conditions such as infection or reaction to prescription drugs
What are some abnormal brain structures with Alzheimers
increased atrophy of brain tissue
neurofibrillary tangles: twisted masses of protein fibers found inside nerve cells
Senile plaques: composed of parts of neurons surrounding a group of proteins called beta-amyloid deposits
tangles and plaques disrupt transmission between neurons
What is the etiology of Alzheimers
genetics and environmental
Twins found heritability is high but environmental influences also important
Autosomal-dominant Alzheimers disease
APOE-e4 gene as a risk gene
How to prevent Alzheirmers
maintaining a healthy cardiovascular system can reduce the risk
changes in lifestyle may slow the progression
Anti-inflammatory drugs may slow the accumulation of proteins implicated in Alzheimer’s
What is Lewy body Dementia
visual hallucinations, cognitive fluctuations, atypical movements
second most common(30%)
results in progressive cognitive decline and milder Parkinsons movement symptoms
more rapid onset than AD(Alzheimer’s), but similar onset
What are some characteristics of Lewy Body Dementia
-significant fluctuations in attention and alertness
-recurrent detailed visual hallucinations
-frequent falls, a shuffling gait, muscular rigidity, and slowed movement
-sleep disturbances
-depression is common
How is LBD similar with other neurocognitive disorders
same irregularities in neurons seen in Parkinson’s, LBD diagnosed when the cognitive decline begins within a year of Parkinson’s like motor symptoms
have plaque/tangles seen in AD
data is compromised due to overlap of symptoms in other dementia
confirmed through autopsy
What is frontotemporal lobar degeneration
brain degeneration in the frontal and temporal lobes resulting in a progressive decline in language and behavior
the fourth leading cause of dementia
What are the symptoms depending on in Frontotemporal lobar degeneration
changes in behavior and personality
difficult using words or naming objects
difficulty forming words and using language
What are some characteristics of Frontotemporal Lobar Degeneration
midlife
complex diagnosis and treatment
significant genetic component
significant genetics component
What is Parkinsons
progressive disorder chatacterized by poorly controlled moto movements
2nd most common(500,000)
What are the 4 common symptoms of parkinsons
tremor of hands, arms, legs, jaw, or face
rigidity of limbs and trunk
slowness in initiating movement
impaired balance and coordination
How to treat parkinsons, and how it combined with Lewy body
motor area of the brainstem and accelerated aging of neurons, and loss of dopamine
medication but there are severe side effects
surgical procedures on brain or implantation of electrodes to stimulate areas of the brain
What is Huntingtons
a genetically transmitted degenerative disease characterized by involuntary twitching movements and eventual dementia
age of onset is variable, ranging from childhood to late life
early symptoms: twitch in fingers or facial grimaces
How does Huntington progress
-abrupt repetitive movements
-changes in personality and emotional stability
-cognitive deficits and dementia
-severe motor and cognitive impairments
-major depression
-no cure, but can be reduced by medication
What is AIDS Dementia complex symptoms
Dementia may be the first sign of AIDS
-inability to concentrate, difficulty with complex mental tasks, tremors, poor balance, and increased apathy and lethargy
ADC among AIDS people are 10-20%
What is Meningitis
inflammation of the membrane surrounding the brain and spinal cord
symptoms vary with age
can result in the destruction of brain tissues
result of virus/bacteria
What is Encephalitis
brain inflammation, many make a complete recovery
result of virus/bacteria
What is Epilepsy
a chronic disorder characterized by seizures resulting from uncontrolled electrical discharge in the brain
most common neurological disorder
1-2% of pop, 2.7 million
Etiology: tumors, injury, degenerative disease, substance abuse
medication not always helpful
What are some major interventions
-rehabilitative techniques
-medical techniques
-cognitive behavioral techniques
-lifestyle changes
-environmental support
-caregiver support
What type of rehabilitation can be done
must be comprehensive and sustained
physical, occupational, speech, and language therapy
individual must be committed
depression, pessimism, and anxiety can stall progress
therapy provided by robotic devices show promising results
How does medication help
can prevent, control, or reduce symptoms
target physical symptoms or cognitive decline
help control comorbid emotional problems
must balance positive and negative effects
What are some cognitive behavioral approaches
psychotherapy can enhance coping and participation in rehabilitation efforts
can also be used to reduce the frequency and severity of problems behaviors or to improve functional skills
How can life style changes help
prevent or reduce progression of neurocognitive disorders
mental stimulation to prevent and reduce cognitive decline
mental exercises can improve memory, reasoning ability, and info processing speed
How can environmental support help
neurodegenerative disorder involving dementia are irreversible and can be best managed with supportive environment
modifying environment can increase safety and comfort while decreasing confusion and agitation
How can caregiver support help
family and friends who provide care in need of support
may feel overwhelmed, helpless, frustrated, or angry
can benefit from caregiver support groups
