Memory Disorders Flashcards
DSM-5 major/mild neurocognitive disorder
-evidence of significant/modest cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, social cognition based on:
-concern of the individual, a knowledgeable informant, on the clinician that there has been a significant/modest decline in cognitive function
AND
-a substantial/modest impairment in cognitive performance, preferably documents by standardized neuropsychological testing or another qualified clinical assesment
-the cognitive defect interferes with/ or does not independence in everyday activities (requiring assistance)
-the cognitive defects do not occur exclusively in the context of a delirium
-the cognitive defects are not better explained by another mental disorder
summary of DSM-5
- evidence, concern for decline
- impairment in cognitive performance (tested)
- interferes
- not anything else
etiologies
- AD
- frontotemporal lobar degeneration
- lewy body disease
- vascular disease
- TBI
- substance/med abuse
- HIV infection
- prions
- Parkinson’s
- Huntington’s
- another medical condition
- multiple etiologies
- unspecified
prevalence
- older a far more likely to suffer from severe as well as mild cognitive impairment
- race and educational status have more prevalence, may be related-whites more educated
prevalence of TBIs
- 1.5 million cases/ year
- 1.1 mil treated and released
- 235,000 hospitalized
- 50,000 die
- 80,000 experience onset of long term effects
- 5.3 million Americans live with a disability as result of TBI
- dwarfs other medical conditions
major risk factors for TBIs
- males 1.5-2x
- ages 0-4- abuse
- 15-19- driving
- over 75- falling
- military service
- participation in contact sports
TBI
- insult to the brain, not degenerative
- caused by external physical force
- may produce diminished or altered state of consciousness
- results in impairment of cognitive abilities or physical functioning
- can also cause behavior or emotional disturbances
- temporary or permanent
- can cause partial or total functional disability or psychosocial maladjustment
neuropsychological assesment
- based on demonstrated links between brain anatomy/ function and behaviors
- test some aspect of behavior- attention, language, memory
- infer something about brain functions- location, type/ degree of impairment
- neurologists focus on structure and physiological consequences of illness or injury
- neuropsychologists focus on cognitive and behavioral consequences of injury or illness-functional capacities
referrals
- usually to determine the nature and degree of impairment, rather than if there is one
- after TBI-car accident, gun shot
- brain tumors, infections, strokes
- AD, parkinsons-neuro diseases
- medical diseases-PKU, Williams
- developmental disorders -autism
- part of comprehensive psychological or psychoeducational evaluation
Rey-Osterrieth complex figure
- ask to copy then to draw for memory
- change color on copy- allows you to see how person views picture
- parts or whole
- non-verbal LTM/ spatial
degenerative disease/ TBI
- gyri much deeper
- atrophy
california verbal learning test
- auditory/ verbal LTM
- list A, then ask them how many they remember
- 5 trials- average for 20s is 8-12 progression then remain at 12 for other tests
- read list B and ask to recall list B- about 6
- then recall A again- still 12
- then grouping by category
- then long term A and grouping again
- then recognition
purpose of california verbal learning test
- can distinguish between learning/attention problem and memory impairment
- ability to learn and retain verbal information
- differentiation between depression and neurological disorders
- detecting brain damage in patients with TBI, drug abuse, and other brain damage
- characterizing memory profiles in patients with schizophrenia, depression
- detection of inadequate effort of malingering
- Dementia patients- recognition distinctly greater than recall (more than normal even)
working memory
- 2 back test
- buzz when see or hear cue that was the same as two back
- can be n back
- attention vs working memory-continuous performance test
- digit span
