Memory disorders Flashcards
what makes a neurocognitive disorder a major disorder?
SIGNIFICANT cognitive decline from PREVIOUS level of performance in 1 or more cognitive domains: complex attn, executive fnc, learning & memory, language, perceptual motor, or social recognition.
what makes a neurocognitive disorder a minor disorder?
MODEST cognitive decline from PREVIOUS level of performance in 1 or more cognitive domains: complex attn, executive fnc, learning & memory, language, perceptual motor, or social recognition.
What are the criteria for the DSM-5
- concern of significant/modest decline in cognitive fnc
- substantial/modest impairment in cognitive performance (usu tested by) neuropyschological tests ( or another quantified clinical assessment).
- cognitive deficits interfere w/ ( in case of major) or does not interfere ( in case of mild) independence in everyday activities.
- cognitive deficits son’t occur only in context in of a delirium
- cognitive deficits are not better explained by a mental disorder ( e.g. schizophrenia)
why is it hard to diagnose ppl with cognitive disabilities?
b/c their fnc on tests is already low and to measure a decline in fnc it has to be extremely low.
in what populations are neurocognitive disorders most prevalent?
older ppl, minorities, and less educated populations.
what is a TBI?
an insult to the brain that isn’t degenerative, or congenital but due to external physical force.
how prevalent is TBI?
there ar est.1.5 mil a yr. in the US
major risk factors for TB include?
being male ( 1.5- 2X higher risk),
age, (0-4 child abuse)
15-19 ( driving)
elderly ( falls)
participation in contact sports,
military service
how do the focuses of neurologists and neuropsychologists differ?
neurologist focus on structure and physiological consequences
neuropsychologists focus on cognitive and behavioral consequences.
why do pts get referred to neuropsychologists?
to determine the nature and degree of impairment rather than to asses if an impairment is present.
what is the rey-osterrieth complex
Patients are provided with blank sheets of paper and told to draw the complex figure as best as they can. There is no time limit set for the copy and recalls. Each patient is asked to copy the figure presented from a landscaped viewpoint, immediately thereafter (immediate recall) from memory and then 20-min later (delayed recall), with no previous warnings on the recalls. During the 20-min interval the patients are administered other tests.
The ROCF copy is sensitive to neurological dysfunction, especially the right parietal region.
The ROCF Recalls are sensitive to neurological dysfunction in the medial temporal lobes.
How did the 86 year old with dementia perform on the rey-osterrieth test and what does it say about him?
poorly, he is part oriented rather than seeing the whole picture.
how does the California Verbal Learning Test – 2nd edition (CVLT-II) work?
CVLT–II involves the oral presentation of a 16-word list (List A) over five immediate-recall trials. An interference list (List B) is then presented for one immediate-recall trial, followed by short- and long-delay free- and cued-recall and recognition testing of List A. During the long-delay interval (approximately 20 min), nonverbal testing is administered to the subjects.
what does the California Verbal Learning Test – 2nd edition (CVLT-II) test?
evaluate auditory / verbal learning and memory
what does the rey-ostrerrieth test, analyze?
evaluate spatial abilities and nonverbal memory
How to dementia pt’s perform on recall compared to recognition in the California Verbal Learning Test?on test
They do much much better on recall
what can the California Verbal Learning Test detect ( 6 things)?
- distinguish between learning/attention problem and memory impairment
- differentiation between depression and a neurological disorder ( like alzheimer’s)
- detecting brain damage in pts w/ TBI, drug abuse, and other brain damage,
- characterizing memory profiles of pts with schizophrenia, depression, etc
- detection of inadequate effort or malingering ( making stuff up about having a disorder)
why does the 2-back exercise test?
working memory
how does the 2 back exercise work?
In the N-back task patients are presented with a stream of stimuli, and the task is to decide for each stimulus whether it matches the one presented N items before.
There are both auditory and visual administrations of the N-back
what does a poor 2 back performance suggest?
Prefrontal lobe dysfunction (especially dorsolateral PFC) is associated with poor performance on the N-back tasks
what is a Digit Span Forward and Backward?
the patient is read a list of numbers at the rate of 1 per second (e.g., 8-3-2-4-7-1-5) and then asked to recall either forward or backward depending on the task
what does a Digit Span Forward and Backward measure?
Digit span forward is generally considered a measure of short term memory
Digit span backward is generally considered a measure of working memory
