Memory Disorders Flashcards
What is the difference between a major and a minor neurocognitive disorder?
major- significant cognitive decline from a previous level of performance, interferes with quality of function
minor- modest decline, doesn’t affect function
To diagnose a neurocognitive disorder what must be fulfilled?
- cognitive decline from previous level of performance in one or more cognitive domains
- evidence of the impairment in performance on standardized neuropsych testing
- deficits don’t occur exclusively in context of delirium or from another mental disorder
How has neurocognitive disorder prevalence changed since the 1980s?
increased
What are predisposing factors for neurocognitive disorders?
older, African American, Hispanic, lower educational level
How is impairment measured in neuropsychological testing?
calculated based on errors in the exam or refusal to answer items on the exam
Where do you expect to see atrophy for a patient with decline in memory?
hippocampus and medial temporal lobe
What is a TBI (traumatic brain injury)?
injury to brain caused by external physical force that may produce a diminished or altered state of consciousness resulting in impairment of cognitive or physical functioning
What is a common example of a mild TBI?
concussion
What are major risk factors for TBI?
males, age 0-4 (child abuse), 15-19 (driving), >75 (falls), military service, participation in contact sports
On what premise are neuropsychological assessments based? What do you measure and what can you infer from this?
- based on demonstrated links between brain anatomy/function and behavior
- test some aspect of behavior that can be measured/recorded
- infer something about brain function and location of impairment based on the brain-behavior correlation
What consequences of injury/illness do neurologists focus on? neurophysiologists?
neurologists focus on structure and physiological consequences
neuropsychologists focus on cognitive and behavioral consequences (functional capacities)
What is the Rey-Osterneth complex figure used to evaluate?
spatial abilities and nonverbal memory
What are the steps of the Rey-Osterneth test?
- Copy the complex figure as best they can with no time limit
- Immediately after, draw the complex figure from memory (immediate recall from memory)
- 20 minutes later, draw the complex figure from memory (delayed recall from memory)
What is the Rey-Osterneth complex figure copy sensitive to?
neurological dysfunction, especially in right parietal region
What are the Rey-Osterneth complex figure recalls sensitive to?
neurological dysfunction in the medial temporal lobes
What is the California verbal learning test used to evaluate?
auditory and verbal learning/memory
What are the steps of the California verbal learning test?
- oral presentation of 16 wordlist (list A) with 5 immediate recall tests.
- interference list (list B) presented for 1 immediate recall trial
- short and long delay free recall of list A
- short and long delay cued recall of list A
- recognition testing of list A
What strategy can be used to improve performance on the California verbal learning test?
semantic clustering of the words into categories (vegetables, furniture etc)
What type of memory is more often spared than recall memory in dementia?
recognition memory
What does the N-back test evaluate?
working memory
What is the task in an N-back test?
patient is presented with stream of stimuli and task is to decide and respond for each stimulus whether it matches the same stimulus presented N items before
What neurological dysfunction is poor performance on N-back test associated with?
prefrontal lobe dysfunction, especially dorsolateral prefrontal cortex
What must be included for N-back testing to make sure it is a working memory disorder?
an attention test to rule out attention deficits causing poor performance
What is the digit span forward a measure of?
measure of short term memory
What is the digit span backwards a measure of?
measure of working memory
What occurs in a digit span forward and backward test?
the patient is read a list of numbers at a rate of 1 per second and asked to recall either forward or backwards depending on the task
