Neurocognitive Disorder

Question 1

Define cognition

Answer 1

Mental functions by which knowledge is acquired, retained and used

Question 2

List the domains of cognition

Answer 2

Complex attention
Learning and memory
Higher functioning
Language
Social cognition
Perceptual motor

Question 3

Difference between major and minor NCD

Answer 3

Mild = no interference with activities of daily living
Major = interference with activities of daily living

Question 4

Cognitive symptoms of neuro cognitive disorder

Answer 4

Forgetfulness (initially short term memory)
Agnosia
Aphasia
Disorientation
Thinking takes longer
Makes mistakes in previously routine tasks
Can’t focus when there are distractions

Question 5

Behavioural symptoms of neurocognitive disorder

Answer 5

Depression
Irritability
Agitation
Sundowning = disruptive at nighttime
Sleep disturbances
Wandering
Psychosis
Personality changes

Question 6

Functional symptoms of neurocognitive disorder

Answer 6

Self-neglect
Apraxia
Cannot manage finances/make decisions

Question 7

Executive functioning problems in neurocognitive disorder

Answer 7

Needs help in planning tasks
Requires effort to follow conversations
Fatigue = effort to plan and make decisions
Eventually relies on others to make decisions

Question 8

Language domain problems in neurocognitive disorder

Answer 8

Struggles to find words and substituted descriptive terms
Language becomes more vague
Can progress to mutism

Question 9

Perceptive motor domain problems in neurocognitive disorder

Answer 9

Becomes easily lost
Struggles with tasks that need special skills
Driving and using tools becomes difficult

Question 10

Social cognition problems in neurocognitive disorder

Answer 10

Change in personally (disinhibition, apathy, decreased empathy)
Lacks insight

Question 11

Causes of neurocognitive disorder

Answer 11

Alzheimer’s
Frontotemproal
HIV
Lest Bodies
Vascular
TBI
Parkinson’s disease
Substance/medication induced
Another medical condition
Multiple aetiologies
Unspecified

Question 12

Specifiers for NCD

Answer 12

With or without behavioural disturbances

Question 13

Potentially modifiable Risk Factors for Vascular Neurocognitive Disease

Answer 13

Poor Education
Hearing loss
TBI
HPT
Alcohol
Obesity
Smoking
Depression
Social isolation
Physical inactivity
Diabetes
Air pollution

Question 14

Complications of Dementia/NCD

Answer 14

Behavioural and psychological symptoms (neuropsychiatric sx)
>emotional and intellectual deterioration
>depression
>anxiety
>irritability
>perplexity and suspicion
>blunting +/- lability

Question 15

MMSE scoring of impairment

Answer 15

20-24 = mild (medications, driving, finances, cooking)
15-19 = moderate (dressing, grooming, bathing)
10-14 = moderately severe (incontinence, lost at home)
<10 = severe (poor speech, poor mobility, poor eating)

Question 16

Pharmacological treatment of Neurocognitive Disease

Answer 16

Targets cognitive symptoms (slow progression)
>acetylcholinesterase inhibitors: increase ACh
=donepezil 5-10mg/day
=galantamine 4-12mg bd
=rivastigmine 1.5-6mg bd

> partial glutamate receptor antagonist
=memantine 5-10mg bd