NCD Dx & Class- 15A

Question 1

Rule of thumb regarding prevalence of dementia.

Answer 1

Prevalence of dementia doubles every 5 years starting at age 65y

Question 2

Criteria for MAJOR Neurocognitive Disorder

Answer 2

-significant cognitive decline in at least 1 domain (best confirmed by neuropsychological testing)
AND
-decrease in independent function

Question 3

Criteria for MILD Neurocognitive Disorder

Answer 3

-modest cognitive decline in at least 1 domain
AND
-DOES NOT interfere with independent function (and may require increased effort or use of compensatory strategies)

Question 4

The main differences between Major NCD and Mild NCD

Answer 4

• significant (major) vs modest (mild) cognitive decline
• interference (major) vs non-interference (mild) with independent daily activities
• major requires assistance with complex IADLs
• mild uses increased effort or compensatory strategies to accomplish complex IADLs
• only MAJOR has severity specifiers: mild, moderate, severe

Question 5

Define the following disorders of neurocognitive domains:

• dysexecutive syndrome
• amnesia
• agnosia
• apraxia
• aphasia

Answer 5

• dysexecutive syndrome: disorder of executive function (planning, decision making, etc)
• amnesia: disorder of learning or memory
• agnosia: lack of knowing/recognition in the presence of intact sensory function
• apraxia: loss of memory for procedures and how to use things
• aphasia: disorder of language

Question 6

Prevalence of neuropsychiatric symptoms in neurocognitive disorders

Answer 6

• 2/3 of NCD have mild neuropsychiatric symptoms

- 1/3 of NCD have severe neuropsychiatric symptoms

Question 7

What are other termsfor pseudodementia associated with depression

Answer 7

• DCI: depression with cognitive impairment

- DSD: dementia syndrome of depression

Question 8

Characteristics of DSD

Answer 8

• depression first followed by cognitive impairment
• abrupt onset
• prominent lack of effort, amotivation, “I don’t know”
• improves with antidepressant treatment

Question 9

Top 3 NCD’s

Answer 9

• Alzheimer’s Disease (66%)
• Lewy Body Disease (20%)
• Cerebrovascular disease (15%)

All other causes account for remaining 19%

Question 10

Name the amylioidopathies

Answer 10

Alzheimer’s Disease

Question 11

Name the Synucleinopathies

Answer 11

• NCD due to Parkinson’s Disease
• NCD with Lewy Bodies
• Multisystem Atrophy

Question 12

Name the Tauopathies

Answer 12

• Alzheimer’s disease
• Down’s Syndrome
• Pick’s Disease
• Progressive supranuclear palsy
• Corticobasal degeneratiion
• FTDP-17 (Parkinsonism linked to chr. 17

Question 13

Describe the general presentation of cortical NCDs

Answer 13

• loss of cognitive function
• 4A’s: amnesia, aphasia, agnosia, apraxia
• prime example: Alzheimer’s disease

Question 14

Describe the general presentation of sub-cortical NCDs

Answer 14

• loss of coordination of cognitive function
• 4D’s: dysmnesia, delay, depletion, dysexecutive
• apathy, personality change, attentional dysfunction, urinary incontinence
• examples: Parkinsons, Huntingtons, Wilson’s Disease, NPH