Chapter 13: Neurocognitive Disorders

Question 1

Neurocognitive disorders intro

Answer 1

These are disorders in which a clinically significant deficit in cognition or memory exists, representing a significant change from a previous level of functioning.

Question 2

Delirium

Answer 2

Characterized by a disturbance in level of awareness and a change in cognition. Develops rapidly over a short period (hours or days).

Up to 80% of ICU patients, 83% end of life patients.

Acute change. Shouldn’t be in psych ward common after being on a ventilator.

Question 3

Delirium and medical issues

Answer 3

Can have an underlying systemic illness. Duration is usually brief and subsides completely on recovery from underlying cause.

UTIs, BPH—>kidney damage — > delirium

Question 4

Predisposing factors or delirium

Answer 4

People over the age of 50 are at higher risk for this. Mostly due to risk of chronic disease.

Infections, febrile illnesses, head trauma, seizures

Question 5

Substance induced delirium

Answer 5

Can be prescribed meds like anticholinergics or even steroids. People all each differently to meds.

Lots of S/E with prednisone

Toxins, alcohol, cannabinols, cocaine, others.

Lead, mercury, carbon monoxide, etc.

Question 6

Tx Suggestions

Answer 6

Minimize some senses

Lights and noise down…maybe use earplugs?

Less lines is better

Bring in comforting pics

If using haloperidol in elderly, us really small amount.

Room near nurse’s station

Question 7

Mild & Major NCD

Answer 7

Minor neurocognitive impairment has also been called mild cognitive impairment. Like brain fog during + after COVID

Major NCD constitutes what was previously called dementia.

Question 8

Primary NCDs

Answer 8

Are those in which the disorder itself is the major sign of some organic brain disease not directly related to any other organic illness (e.g. Alzheimer’s)

Question 9

Secondary NCDs

Answer 9

Are caused by or related to another disease of conditions (e.g. HIV disease or cerebral trauma)

Question 10

Symptoms of NCDs

Answer 10

Can totally change what a person would normally do.

Impairment exists in abstract thinking, judgment, and impulse control.

Some may revert to their 1st language.

Aphasia can lead to no being able to talk anymore. They know what they wanna say but they can’t say it.

Question 11

Reversible NCDs (temporary dementia) can result from

Answer 11

Stroke, depression, side effects of meds, nutritional deficiencies, CNS infections, metabolic disorders.

May see pseudo-dementia in people with depression.

B12 deficiency can cause psych illness that can be treated.

Question 12

Most NCDs are reversible and follow a progressive course. These symptoms may include…

Answer 12

Aphasia

Apraxia —> Motor function impairment

Inability to care for personal needs

Wandering

Incontinence

Agnosia: Inability to interpret things. What should I do with this pen?

Question 13

NCD: Alzheimer’s disease

Answer 13

50 - 80% of all NCD cases

Described in 7 stages