Memory Disorders

Question 1

What is the difference between a major and a minor neurocognitive disorder?

Answer 1

major- significant cognitive decline from a previous level of performance, interferes with quality of function
minor- modest decline, doesn’t affect function

Question 2

To diagnose a neurocognitive disorder what must be fulfilled?

Answer 2

• 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

Question 3

How has neurocognitive disorder prevalence changed since the 1980s?

Answer 3

increased

Question 4

What are predisposing factors for neurocognitive disorders?

Answer 4

older, African American, Hispanic, lower educational level

Question 5

How is impairment measured in neuropsychological testing?

Answer 5

calculated based on errors in the exam or refusal to answer items on the exam

Question 6

Where do you expect to see atrophy for a patient with decline in memory?

Answer 6

hippocampus and medial temporal lobe

Question 7

What is a TBI (traumatic brain injury)?

Answer 7

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

Question 8

What is a common example of a mild TBI?

Answer 8

concussion

Question 9

What are major risk factors for TBI?

Answer 9

males, age 0-4 (child abuse), 15-19 (driving), >75 (falls), military service, participation in contact sports

Question 10

On what premise are neuropsychological assessments based? What do you measure and what can you infer from this?

Answer 10

• 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

Question 11

What consequences of injury/illness do neurologists focus on? neurophysiologists?

Answer 11

neurologists focus on structure and physiological consequences
neuropsychologists focus on cognitive and behavioral consequences (functional capacities)

Question 12

What is the Rey-Osterneth complex figure used to evaluate?

Answer 12

spatial abilities and nonverbal memory

Question 13

What are the steps of the Rey-Osterneth test?

Answer 13

1. Copy the complex figure as best they can with no time limit
2. Immediately after, draw the complex figure from memory (immediate recall from memory)
3. 20 minutes later, draw the complex figure from memory (delayed recall from memory)

Question 14

What is the Rey-Osterneth complex figure copy sensitive to?

Answer 14

neurological dysfunction, especially in right parietal region

Question 15

What are the Rey-Osterneth complex figure recalls sensitive to?

Answer 15

neurological dysfunction in the medial temporal lobes

Question 16

What is the California verbal learning test used to evaluate?

Answer 16

auditory and verbal learning/memory

Question 17

What are the steps of the California verbal learning test?

Answer 17

1. oral presentation of 16 wordlist (list A) with 5 immediate recall tests.
2. interference list (list B) presented for 1 immediate recall trial
3. short and long delay free recall of list A
4. short and long delay cued recall of list A
5. recognition testing of list A

Question 18

What strategy can be used to improve performance on the California verbal learning test?

Answer 18

semantic clustering of the words into categories (vegetables, furniture etc)

Question 19

What type of memory is more often spared than recall memory in dementia?

Answer 19

recognition memory

Question 20

What does the N-back test evaluate?

Answer 20

working memory

Question 21

What is the task in an N-back test?

Answer 21

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

Question 22

What neurological dysfunction is poor performance on N-back test associated with?

Answer 22

prefrontal lobe dysfunction, especially dorsolateral prefrontal cortex

Question 23

What must be included for N-back testing to make sure it is a working memory disorder?

Answer 23

an attention test to rule out attention deficits causing poor performance

Question 24

What is the digit span forward a measure of?

Answer 24

measure of short term memory

Question 25

What is the digit span backwards a measure of?

Answer 25

measure of working memory

Question 26

What occurs in a digit span forward and backward test?

Answer 26

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