Neurocognitive disorders Flashcards
What are the cause of neurocognitive disorders?
-Physical or medical causes (not psychologically based)
—Cause can be directly determined (unlike psychological disorders)
What do the neurocognitive disorders have?
-Disorders have very specific symptom set or pathology
What are true about neurocognitive disorders?
Subject of very extensive research and have a lot of concesice
What do neurocognitive disorders affect?
Affect brain functioning
What are the deficiencies in neurocognitive disorders?
Deficits in cognitive functioning
What are the marked changes in neurocognitive disorders?
Marked change in prior level of functioning
What is delirium?
a disturbance in attention and awareness (change)
How does delirium develop?
Develops over short period of time, fluctuates in severity
What are additional disturbances in cognition (with delirium)?
-Usually recent memory impairment
-Person disoriented
—Person, place and time
—Sometimes people don’t know who they are
-Perceptual disturbances
—Misinterpreting stimuli, hallucinations
What are the causes of delirium?
-Head injury
-Stroke
-CNS disorders
-Metabolic disorders
-Underlying medical conditions
-Drug abuse and withdrawal
-Fluid imbalance
-Vitamin B deficiency
Is delirium reversible?
-Some causes reversible; delirium will clear
—VItamin B deficiency
How do you diagnose delirium?
Make sure not due to person being in coma, other psychological issue
What are major neurocognitive disorders?
-Profound decline or deterioration
—Can interfere with person’s ability to care for themselves
What are the causes of major neurocognitive disorders?
Multiple causes
In what cases can may major neurocognitive disorders?
-May be reversible in some cases
—Removable brain tumor
—Treatable infections
—Depression
—Substance abuse
What is mild neurocognitive disorders?
-Mild or modest decline in cognitive functioning
—Using greater compensatory skills, difficulty using language, people with high levels of intelligence can delay others knowing they have difficulties
What is important about mild neurocognitive disorders?
-Important new diagnosis
—Allows for early intervention
What is the most common cause of neurocognitive disorders?
-Neurocognitive disorder due to alzheimer’s disease
—Most common cause of neurocognitive disorder
What is common with neurocognitive disorders due to Alzheimer’s?
Dementia (memory impairment) and deterioration of other cognitive functions
What are examples of the deterioration of other cognitive functions due to Alzheimer’s?
-Trouble with word-finding
-Forgetfulness
-Visual-spatial deficits
-Impaired judgment
What is trouble with word finding?
-Trouble with word-finding: cannot remember commonly used scores
—Tests compared to others age
What are the visual-spatial deficiencies seen in Alzheimer’s?
-People get lost
-Get in car to go to the grocery store and end up somewhere else
What the timeline of neurocognitive disorders due to Alzheimer’s like?
-Early-on: subtle personality changes that become more progressive
-Insidious onset, gradual, steady progression
—As progresses, may forget long-term memory like how to subtle
——Insidious = subtle
What causes the neurocognitive disorders due to Alzhiemer?
-No evidence of other cause
–unlike stroke or delirium
What does the research on neurocognitive disorders due to Alzheimer’s?
-Unsure what causes
-No effective treatment
-Perhaps development of neurofibrillary tangles and amyloid plaques
-Some people have these but do not have alzheimer’s
What are neurofibrillary?
Neurofibrillary: twisted fibers that consist of protein called TAU impairs structure of neurons involved in transport
What are amyloid plaques?
Amyloid plaques: beta-amyloid protein (in normal brains broken down and eliminated) accumulate and become hard, insoluble plaques interfering with neurons
What is the prevalence of alzheime?
-Prevalence of alzheimer’s disease among older adults
-Not typical of age development but more at risk with age
-Prevalence increased because age of death is getting older
What is the second leading cause of neurocognitive disorders?
Vascular neurocognitive disorder
What does vascular mean?
dealing with blood vessels
What is the onset of vascular neurcognitive disorders?
-Onset of cognitive deficits due to cerebrovascular accident (stroke)
—Usually blood clot in brain blood vessel causing
How does vascular neurocognitive disorder typically occur?
Typically occurs abruptly and follows stepwise progression with rapid decline
How can you tell what side the stroke occurs on?
-Stroke on left side: aphasia (language impairment)
—Assume on right side of brain if no language impairment
What is front-temporal neurocognitive disorder?
-Deterioration of brain tissue in frontal and temporal lobes
-Memory loss (not as severe as alzheimers) and inappropriate social functioning
What is important about the structures involved in fronto-temporal neurocognitive disorder?
-Frontal lobes inhibit our actions
—Typical behavioral components: apathy, etc.
-Temporal lobes role in storage of memories
What evidence is there that neurocognitive disorder is due to traumatic brain injury?
-Evidence of traumatic brain injury
-Specific deficits vary with injury site, age, etc
What is the most common neurocognitive disorder due to traumatic brain injury
Most common: short term memory
What improves your prognosis?
Younger a person is, better prognosis is due to brain malleability in younger years
What is typical of neurocognitive disorders due to traumatic brain?
Loss of consciousness typical
What are the neurological signs of neurocognitive disorders due to traumatic brain?
Neurological signs: seizure activity, lose certain areas of function
What is common of neurocognitive disorders due to traumatic brain injury?
-amnesia: forgetting
What are the different types of amnesia?
-Anterograde: if person can’t remember things from time brain injury occurred forwards
-Retrograde: person can’t remember what happened before
What is the spectrum of neurocognitive disorder due to traumatic brain injury
Mild - moderate - severe
What is a mild form of neurcognitive disorder due to traumatic brain?
-Mild: concussion
—Multiple concussions can cause repetitive damage
What is substance or medication induced neurocognitive disorder?
-Criteria met for neurocognitive disorder
-Involved substance or medication capable of producing neurocognitive impairment
What is common about the course of substance or medication induced neurocognitive disorder?
Course of neurocognitive deficits consistent with timing of substance use
What is alcohol induce neurocognitive disorder?
memory and impairment of typical cognitive functioning
What are examples of substance or medication induced neurocognitive disorders?
-Korsakoff syndrome
-Wernicke’s disease
What is Korsakoff syndrome?
-Korsakoff syndrome: substance-induced neurocognitive
—Chronic heavy alcohol abuse
—Irreversible memory loss due to vitamin B1 deficiency
—Different because the loss of long-term memory first
What is Wernicke’s disease?
-Wernicke’s disease: heavy alcohol use, and vitamin B1 deficiency
—Eye movement paralysis
What is neurcognitive disorder with lewy bodies?
-Profound cognitive decline
-Fluctuating alertness and attention
-Visual hallucinations
-RIgid body movements and muscle stiffness
What are Lewy bodies?
Lew body’s: abnormal protein deposits in nuclei of brain cells –> disruption of process involving memory and motor control
What is neurocognitive disorders due to Parkinson’s?
-Parkinsons: deterioration of substantia nigra and dopamine deficiency
—Uncontrollable tremors, shaking, rigid muscles, walking difficulties
-Majority of patients will develop major NCD or dementia
What is the treatment of neurocognitive disorders due to Parkinson’s?
Medication: L-dopa that increases dopamine and can reduce some of the symptoms but no cure
What are neurocognitive disorders due to Huntington’s disease?
-Huntington disease: inherited degenerative disease
-Mental deterioration
-Choreiform movements and motor impairments
-Insidious onset and gradual progression
What is choreiform movements and motor impairment?
-Chorea: dance in greek
–Involuntary twisty, jerky movement of face limb and trunk
——apart of Huntington’s disease
What is mental deterioration (Huntington’s disease)?
Progressive cognitive impairment
What is the insidious onset and gradual progression of Huntington’s disease?
Cognitive symptoms usually decline first
What is the median survival of Huntington’s disease?
Median survival after diagnosis: 15 years
What are the neurocognitive disorders due to HIV?
-Impaired executive functioning
-Slowed processing speed
-Difficulty with demanding attentional tasks
-Difficulty with new learning
What is impaired executive functioning due to HIV?
Decreased ability to concentrate and portable solve
How do you test slowed processing speed due to HIV?
Testing: sorting beads by color
What are the neurocognitive disorders due to prion disease?
Formation of abnormal cluster of prion molecules —> infection —–> brain damage —> major NCD
What are two examples of neurocognitive disorders due to prion disease?
-Mad-cow disease in animals
-Creutzfeldt jakob disease
