Neurcognitive Disorders Flashcards
What is delirium characterised by?
Acute decline in both the level of consciousness and cognition with particular impairment in attention.
Typical onset time of Delirium
Classically, delirium has a sudden onset (hours or days), a brief and fluctuating course, and rapid improvement when the causative factor is identified and eliminated, but each of these characteristic features can vary in individual patients.
Associated clinical features of Delirium
Disorganisation of thought process
Perceptual Disturbances
psychomotor hyperactivity and hypoactivity
disruption of the sleep-wake cycle (often manifested as fragmented sleep at night, with or without daytime drowsiness)
mood alterations (from subtle irritability to obvious dysphoria, anxiety, or even euphoria)
The major differential points between dementia and delirium
The time to development of the condition and the fluctuation in level of attention in delirium compared with relatively consistent attention in dementia. The time to development of symptoms is usually short in delirium, and except for vascular dementia caused by stroke, it is usually gradual and insidious in dementia.
Delirium versus schizophrenia or Depression
In general, however, the hallucinations and delusions of patients with schizophrenia are more constant and better organized than those of patients with delirium.
Patients with schizophrenia usually experience no change in their level of consciousness or in their orientation.
Patients with hypoactive symptoms of delirium may appear somewhat similar to severely depressed patients, but they can be distinguished on the basis of an EEG.
What does Dementia refer too?
A disease process marked by progressive cognitive impairment in clear consciousness.
The cognitive deficits in dementia represent a decline from a previous level of functioning.
Dementia involves multiple cognitive domains and cognitive deficits cause significant impairment in social and occupational functioning.
Types of Dementias (9)
Alzheimer's disease dementia of Lewy bodies vascular dementia frontotemporal dementia traumatic brain injury (TBI) HIV prion disease Parkinson's disease Huntington's disease.
Steps for a diagnosis of Dementia
based on the clinical examination, including a mental status examination, and on information from the patient’s family, friends, and employers.
Does a dementia patient have impaired level of consciousness?
No matter how severe the disorientation seems, however, patients show no impairment in their level of consciousness
Dementia of Alzheimers Type versus Vascular Dementia
Classically, vascular dementia has been distinguished from dementia of the Alzheimer’s type by the decremental deterioration that can accompany cerebrovascular disease over time. Although the discrete, stepwise deterioration may not be apparent in all cases, focal neurological symptoms are more common in vascular dementia than in dementia of the Alzheimer’s type, as are the standard risk factors for cerebrovascular disease.
Delirium vs Dementia
In general, delirium is distinguished by rapid onset, brief duration, cognitive impairment fluctuation during the course of the day; nocturnal exacerbation of symptoms; marked disturbance of the sleep-wake cycle; and prominent disturbances in attention and perception
Depression vs Dementia
Often difficult to distinguish from dementia
- Sometimes referred too as pseudodementia but known as “Depression-relation cognitive dysfunction”
These patients typically have more insight into their symptoms than do demented patients, and often a history of depressive episodes.
Factitious disorder vs dementia
Someone who attempts to simulate memory loss, do so in an erratic and inconsistent manner.
In true dementia, memory for time and place is lost before memory for person, and recent memory is lost before remote memory.
Schizophrenia vs dementia
Although schizophrenia can be associated with some acquired intellectual impairment, its symptoms are much less severe than are the related symptoms of psychosis and thought disorder seen in dementia
